At eleven o'clock, on the morning of October 20, 1969, in St. Petersburg, Florida, Kerouac was sitting in his favorite chair drinking whiskey and malt liquor, working on a book about his father's print shop in Lowell, Massachusetts. He suddenly felt nauseated and walked to the bathroom, where he began to vomit blood. Kerouac was taken to a nearby hospital, suffering from an abdominal hemorrhage. He received several transfusions in an attempt to make up for the loss of blood, and doctors subsequently attempted surgery, but a damaged liver prevented his blood from clotting. He died at 5:15 the following morning at St. Anthony's Hospital, never having regained consciousness after the operation. His cause of death was listed as an internal hemorrhage (bleeding esophageal varices) caused by cirrhosis, the result of longtime alcohol abuse.[62][63] A possible contributing factor was an untreated hernia he suffered in a bar fight several weeks earlier.[64][65][66] He is buried at Edson Cemetery, Lowell, Massachusetts.[67]

Grave in Edson Cemetery, Lowell
At the time of his death, he was living with his third wife, Stella Sampas Kerouac, and his mother Gabrielle. Kerouac's mother inherited most of his estate.

He was honored posthumously with a Doctor of Letters degree from his hometown University of Massachusetts Lowell on June 2, 2007.[68]