Context: Infant mortality rate is the number of deaths under one year of age in a year divided by total number of live birth in the same year × 1000. It is a standard measure that is not affected by population age structure and therefore suitable to use for comparisons over time and across regions, in addition, it reflects the underlying well-being of communities and the social environment that cultivate health and access to healthpromoting resources. Aim: Determine the trend of infant mortality in Nineveh for 10 year period (2004-2013). Subjects and Methods: Study Design: Descriptive biometric study design. Study Settings: Nineveh Governorate/ North of Iraq. Study Sample: Infant deaths and live births from 2004 to 2013. Data Collection Tool: Death certificates, vital registration system. Outcome Measures: Infant mortality rate in general in addition to the proportions of their mortality by sex and causes with their trends by using various rates, proportions, and Chisquared test for trend. Results: The trend of infant mortality rate fluctuated significantly from 15.36 to 16.93/1000 live births between 2004 and 2013. Most of these deaths were due to respiratory distress syndrome, sepsis, congenital anomalies, infections, birth asphyxia, and pneumonia. Conclusions and Recommendations: Infant mortality was relatively low and most of its causes were preventable, thus; more efforts are still needed to control such causes and improve infants' survival.