<p>Falls are associated with mortality in older adults; however, evidence on healthcare use preceding fall-related death in Latvia remains limited. This study examined fall-related deaths and hospital and emergency medical service utilisation in the last year of life among adults aged 65 years and older in Latvia. A cross-sectional registry-based study was conducted using national mortality data on individuals who died of falls-related causes (ICD-10 W00–W19) between 2019 and 2023. Mortality records were individually linked to state-funded inpatient and emergency medical service data for the preceding 12 months. The study included 549 fall-related deaths (median age 83 years; 54.6% female). In the year preceding death, 60.7% of individuals had been hospitalised once and 31.7% twice or more, while 47.5% had made one emergency medical service call and 34.1% had made two or more. Most deaths occurred in a hospital (75.8%), with an increasing trend over time. Higher odds of dying in the hospital were observed among individuals with injury-related acute healthcare use and head injuries. These findings highlight the importance of integrated fall-prevention strategies, improved post-discharge follow-up, and coordinated care across emergency, hospital, primary, and community services to reduce fall-related mortality among older adults.</p>