For any distribution π on [n]={1,2,…,n}, we study elements drawn at random from the set scriptAπ of tridiagonal stochastic matrices K satisfying π(i)K[i,j]=π(j)K[j,i] for all i,j∈[n]. These matrices correspond to birth and death chains with stationary distribution π. We analyze an algorithm for sampling from scriptAπ and use results from this analysis to draw conclusions about the Markov chains corresponding to typical elements of scriptAπ. Our main interest is in determining when certain sequences of random birth and death chains exhibit the cutoff phenomenon. © 2016 Wiley Periodicals, Inc. Random Struct. Alg., 50, 287–321, 2017