Levels of premature mortality in England and Wales have declined markedly over time, with the probability of survival to age 75 increasing from 38 to 66 per cent for males, and from 54 to 77 per cent for females, between 1950 and 2004. To assess the application of this measure to monitor premature mortality in sub-national geographical areas, this article presents an analysis of the probability of survival at local authority level. Results for 1981-83 and 2004-06 are presented for Government Office Regions in England, Wales and local authorities in England and Wales. Significant differences in premature mortality are described within, and between, regions. Patterns of probability of survival to age 75 for local authorities are compared with other measures of mortality.