An epidemiological profile describes the burden of diseases on the population of an area in terms of sociodemographic, geographic, behavioral and clinical characteristics of persons with such diseases, as well as the risk factors that underlie the diseases. The profile serves as a valuable tool used at the state and local levels by those who make recommendations to create intervention and prevention strategies, allocate healthcare resources, plan programs and evaluate programs and policies. The paper is a modest attempt to critically analyze the epidemiological profile of Sokoto from the past and contemporary perspective using proportional mortality rate. After a critical evaluation of data on proportional mortality from Sokoto State Health Strategic Plan (2016), we concluded that the high mortality in Sokoto State is attributable to communicable diseases, maternal, perinatal and nutritional conditions (73% of all deaths), although mortality due to Non-Communicable Diseases (NCDs) is also on the rise (NCDs < cancer - 29% of all deaths). This conclusion systematically supported the premise that Sokoto state is experiencing the third stage of epidemiological transition – the age of unfinished set of health problems; rising new health problems and ill-prepared health systems.