Aim <p>Monitoring socioeconomic inequalities in cause-specific mortality is crucial for evaluating public health policies and planning interventions to promote health equity. This study investigates recent trends of educational inequalities in cause-specific mortality in Italy, using data from a census-based cohort with follow-up from 2012 to 2021.</p> Subject and methods <p>We carried out a retrospective cohort study based on the record linkage between the 15th Italian Population Census, the National Register of Transfers of Residence, and the National Register of Causes of Death. The study included 41,855,943 individuals. We evaluated changes in age-standardized mortality rates among individuals aged ≥40 years by educational level and estimated mortality rate ratios comparing individuals with low and intermediate education to those with high education, using quasi-Poisson regression models.</p> Results <p>Between 2012 and 2021, educational inequalities particularly increased among men for colorectal cancer, pneumonia, and diabetes, and among women for breast, lung, colorectal, and cervical cancers. The initial advantage in lung and breast cancers mortality among least educated women disappeared in recent years. Pre-pandemic trends mostly persisted through 2020–2021; inequality in COVID-19 mortality remained stable from 2020 to 2021.</p> Conclusion <p>Findings highlight growing disparities in all-cause and cause-specific mortality in Italy, emphasizing the need for targeted policies to reduce socioeconomic health inequalities.</p>