Description: Trends in mortality have a huge impact on the insurance industry and its products, risks and profitability. Worldwide, life expectancy has increased continuously over the past decades. However, this progress—even without considering the Covid-19 pandemic—has been subject to strong fluctuations. In recent years, an increase in volatility can be observed. Various aspects—medical science, environment, lifestyle—have influenced the trend in the past. How can the life and health industry move forward in these uncertain conditions? In this article, we examine what has gone before and what can be learned from a closer analysis. What are the main drivers of the historical increase in life expectancy? What characterizes the dynamics of the recent past? How can mortality be projected into the future? How good are our methods of prediction and what are the risks? What risk management options are available?