Rationale: Most deaths in the intensive care involve withholding or withdrawing multiple life-sustaining therapies, but little is known about how to proceed practically and how it affects family satisfaction. Objectives: To examine the duration of life-support withdrawal and its association with overall family satisfaction with care in the ICU. Methods: We studied family members of 584 patients who died in an ICU at one of 14 hospitals after withdrawal of life support and for whom complete medical chart and family questionnaires were available. Measurements: Data concerning six life-sustaining interventions administered during the last five days of life were collected. Families were asked to rate their satisfaction with care using the Family Satisfaction in the ICU questionnaire (FS-ICU). Main results: For nearly half of the patients (271/584), withdrawal of all life-sustaining interventions took more than one day. Patients with a prolonged (>1 day) life-support withdrawal were younger, stayed longer in the ICU, had more life-sustaining interventions, less often a diagnosis of cancer and had more decision makers involved. Among patients with longer ICU stays, a longer duration in life-support withdrawal was associated with an increase in family satisfaction with care (p=0.037). Extubation prior to death was associated with higher family satisfaction with care (p=0.009). Conclusions: Withdrawal of life support is a complex process that depends on patient and family characteristics. Stuttering withdrawal is a frequent phenomenon that seems to be associated with family satisfaction. Extubation before death should be encouraged if realizable.