We examined cross-sectional differences and longitudinal changes in episodic memory performance related to impending death among a group of very old people, aged 90–101 years. Participants were assessed at 3 measurement points across a 6-year interval. Three groups were identified: those who survived the entire follow-up period (n =40), those who died before the first follow-up (n =44), and those who died after the first follow-up (n =14). Participants completed a battery of episodic memory tasks consisting of face recognition, word recognition, word recall, and object recall with selective reminding. Those who survived performed better than those who were going to die in object recall at baseline. A Cox regression analysis, controlling age, revealed that object recall performance was significantly related to subsequent mortality status. Longitudinal analyses demonstrated significant 3-year decline for both face recognition and object recall, but no evidence of differential decline as a function of mortality group. Thus, longitudinal changes in memory preceding death were not as pronounced as the corresponding cross-sectional differences in this very old sample. In general, the results suggest that mortality-related memory deficits are present in extreme old age, although these deficits are relatively small and task-specific.