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We compared animals from a caribou (Rangifer tarandus) mortality event in the area of Point Hope and Chariot (Cape Thompson), Alaska (USA) in 1995 to hunter-killed caribou from reference sites (Barrow, Red Dog Mine, and Teshekpuk Lake, Alaska). Gross and histologic endpoints, and element levels (As, Cd, Cu, Pb, Zn, Fe) were evaluated. Starvation/malnutrition were major factors leading to death or severe weakness as very little or no fat (very low body condition scores) and serous atrophy of fat (marrow cavity and histologically) were more prevalent in caribou associated with the mortality event as compared to reference sites animals. Accumulation of hepatic hemosiderin in Kuppfer cells was noted as an indicator of cachexia. Levels of lead in feces and liver, copper the rumen contents, and arsenic in muscle were higher in caribou harvested near Red Dog Mine and might be expected in the mineral rich area, but were not at a level of concern for toxicoses. Kidney levels of cadmium were significantly increased with increasing age, and presents a potential concern for human consumers, and is an expected finding. We concluded that heavy metals played no role in the mortality event and that caribou starved. Further investigation of regional minerals differences is required to understand the sources and transport mechanisms to explain these findings and to properly address mining activity impacts. Mortality events on the north slope of Alaska are not uncommon and likely involve starvation as described here, but in most cases are not investigated, even though recent industrial activities have heightened concern.