The complex and evolving picture of COVID-19-related mortality highlights the need for data to guide the response . Yet many countries are struggling to maintain their data systems, including the civil registration system, which is the foundation for detailed and continuously available mortality statistics . We conducted a search of country and development agency Web sites and partner and media reports describing disruptions to the civil registration of births and deaths associated with COVID-19 related restrictions.We found considerable intercountry variation and grouped countries according to the level of disruption to birth and particularly death registration . Only a minority of the 66 countries were able to maintain service continuity during the COVID-19 restrictions . In the majority, a combination of legal and operational challenges resulted in declines in birth and death registration . Few countries established business continuity plans or developed strategies to deal with the backlog when restrictions are lifted.Civil registration systems and the vital statistics they generate must be strengthened as essential services during health emergencies and as core components of the response to COVID-19 . (Am J Public Health . Published online ahead of print April 15 , 2021: e1-e9 . https: //doi.org/10.2105/AJPH.2021.306203).