Objective: To identify the probable causes of deaths through verbal autopsy and identify the health problems prevalent in underprivileged and marginalized communities. Methods: This was a cross-sectional survey conducted at the community of Nurpur Shahan (Urban Slum), Islamabad, Pakistan in January 2010. W.H.O validated questionnaire was used and 300 adults (age > 18 years) were assessed on their knowledge regarding death of their relatives. All data collected was entered into SPSS version 10.0. The data was re-validated and analyzed. Results: Out of the three hundred deaths, 191(63.7%) were male and 109(36%) were female. One hundred and ninety one (63.7%) deaths were due to heart diseases, 69 (23%) due to accidents and 37(12.3%) due to unknown causes. One hundred and thirty one of the deceased (43.7%) were issued death certificates. Conclusion: This study concludes that heart diseases are the most common cause of death in the urban slum community followed by accidents. A significant proportion of the deaths went unreported which suggests the need of record keeping of such deaths to enrich epidemiological purposes and health and safety interventions in such communities. Ways and means have to be searched to cater to the cardiac health care needs of the underprivileged and marginalized segments of the society.