<p>The urban mortality penalty among Mexican adults aged 60 and older has been acknowledged since the late 20th century, hinting at a rural advantage. However, few studies have analyzed mortality trends to address whether birth cohorts are related to these discrepancies. To identify the role of birth cohorts in changes in mortality trends across urban and rural areas in Mexico. Data from the Mexican Health and Aging Study (MHAS) were used. We reconstructed population death rates and exposures from survivors across different cohorts from 2010 to 2021. Age-period-cohort models were applied, constraining the cohort dimension to determine the role of non-linear (and fully identifiable) cohort effects on urban and rural mortality for Mexicans aged 60 and older. We found non-linear birth cohort effects, with a relative risk of mortality 1.28 (1.08–1.54) times higher than the average trend for males who lived in urban areas and were born between 1930 and 1940. However, we could not identify a clear rural/urban gradient over time. For females, the urban penalty dissipated and was reversed after the 2010s, mostly due to strong linear effects but some cohort effects as well, suggesting that women living in rural areas relative to urban areas had a mortality risk 1.26 times higher (1.06–1.51) for cohorts born between 1935 and 1940. The urban penalty observed in males was likely associated with cohort effects, suggesting that its dissipation could signal the beginning of a new trend, driven by causes of death more likely to affect younger cohorts.</p>