<p>Accurate and timely reporting of deaths due to COVID-19 infection is critical to ongoing public health surveillance and response. Excess mortality reports by the South African Medical Research Council suggest underreporting of COVID-19-related deaths, as routine COVID-19 death surveillance utilizes mainly data on hospitalised patients. SARS-CoV-2 post-mortem testing (PMT) for persons who died of natural causes out-of-hospital was implemented in South Africa and rapid mortality surveillance was optimised at selected districts in the Free State Province (FSP), South Africa. We describe the testing, and positivity rate of PMT in the Mangaung metropolitan area, FSP, from 01 August 2020 to 31 August 2022.</p>