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Through a prospective descriptive study of medical death certificates (MDCs) received by the forensic medicine department of Sfax-Tunisia, our objectives were to study the content of the MDCs, to evaluate the quality of writing, to analyze the writing errors and to propose practical recommendations for the establishment of MDCs.We classified the writing errors into six major and five minor errors. 74 death certificates were collected. The completion of the administrative section was satisfactory with an average of 13 out of 20 criteria met. The four boxes for medico-legal data were completed in more than three quarters of the certificates. The writing of the medical part was the source of almost all the writing errors. The most frequent major error was the mention of the mechanism of death alone without the cause of death in 59.5%. As for the minor errors, the presence of abbreviations was by far the most frequent error (in 87.8% of cases).Our study showed that the quality of death certificate writing suffered from several shortcomings, which encourages us to make more effort in training doctors.