The show uses fiction and documentary to recreate supposed deaths that were unusual deaths. It also includes urban legends of death mysteries and behind each death, the science behind it is explained by a scientist. Some of the content is something that has really happened. A Darwin award has been awarded to some of the deaths. See more details at http://en.wikipedia.org/wiki/1000_Ways_to_Die.
There was supposedly a "Way to Die" that happened in a city in Arizona - that I had never heard of. I looked the city up and - lo and behold - the city they named didn't exist. So I'd have to put in my bit for the show being NOT TRUE.