An important dimension of inequality in mortality is regional variation. However, studies that investigate regional mortality patterns within and between national and regional borders are rare. We carry out a comparative study of Finland and Sweden: two welfare states that share many attributes, with one exception being their mortality trajectories. Although Finland has risen rapidly in the global life expectancy rankings, Sweden has lost its historical place among the top 10. Using individual-level register data, we study regional trends in life expectancy and lifespan variation by sex. Although all regions, in both countries, have experienced substantial improvements in life expectancy and lifespan inequality from 1990-2014, considerable differences between regions have remained unchanged, suggesting the existence of persistent inequality. In particular, Swedish-speaking regions in Finland have maintained their mortality advantage over Finnish-speaking regions. Nevertheless, there is some evidence of convergence between the regions of Finland and Sweden.