Near-death experiences (NDEs) entail complex and structured conscious experience during conditions known to coincide with rapid loss of consciousness often associated with decline or disruption of the neurological correlates currently held to be causative factors of visual imagery and cognition. In this study, 653 NDE reports of cardiac and/or respiratory arrest patients were analyzed for unprompted, spontaneous references to quality of conscious visual imagery and mentation during an NDE. Results indicate that in a majority of NDEs, both figurative and abstract (...) mentation are either preserved or markedly improved during unconsciousness and unresponsiveness in the context of respiratory and cardiac arrests. These findings underscore the call to further study the mechanisms behind the ‘outliving’ of a conscious sense of selfhood and complex, structured visual imagery and cognition during severely deteriorating physiological function—and perhaps especially during clinical death. (shrink)