Akagi dies at the age of 53, on September 26th, 1999. He figures out he's got Alzheimer's. Akagi hated 'not being himself' because of the disease, and was starting to forget about Mahjong... and his left eye was losing its sight... so before all the big things come he decides to die. Akagi can't bear to be like that.. you'll understand considering his personality and philosophy.
Akagi's final thoughts as he dies are 'What's this? Dying is not that scary after all...' He opens his eyes one last time, and then closes them.
After Akagi dies, gamblers secretly take bits of his gravestone for good luck, and so the shape is all ruined. Ten says, "Forgive them, Akagi.. they're doing that because they all like you". Ten and Hiro (another main character) leave the graveyard, and Hiro says that Akagi Shigeru is still in everyone's minds. A cat comes by and sleeps in front of Akagi's now damaged gravestone. The End.