The deaths of an estimated 20 million people (80–90% of the pre-contact population) in central Mexico during the 1500s were overwhelmingly caused by Old World infectious diseases—especially smallpox, measles, influenza, typhus, and mumps—introduced by Spanish conquistadors and subsequent colonists.
Violence, enslavement, cultural destruction, and ecological change (livestock overgrazing, deforestation) compounded the collapse. But the epidemiological shock was the overwhelming driver—one of the greatest demographic disasters in human history.