Demographic change of the Pacific region is analyzed using eight censuses, six demographic surveys, and vital registrations. To some extent, population processes have been similar in the Caribbean and the Pacific regions; however, salient differences were found in comparison to Bogotá and the rest of the country. Despite a systematic reduction on age dependency ratios, the effective dependency ratio remains higher than other Colombian regions, being one of the limits to the economic development of peripheral regions. A retrospective estimation of the under-5 mortality in the Pacific shows a substantial decline within the past few decades, but the gap to the rest of the country represents the negative penalty of being born and living in the less developed regions of Colombia. Indirect estimations of the adult mortality and the life expectancy at working ages lead to the same conclusion.