The word "true" is used because vampires are technically already dead. Due to the possibility of an end, any creature that can experience the True Death is technically not immortal. It is stated several times in the series that vampires are technically not immortal, because, despite their immunity to aging, death always finds them through one means or another in the vastness of eternity.
Administration
In vampire politics, only certain vampires have the authority to command the True Death on other vampires. So far we have seen this power from the Magister, Nan Flanagan, and Roman Zimojic. The Chancellors of the Authority are allowed input into whether a vampire should receive the True Death or not, especially with regards to smaller kingdoms and states, however, should an enemy of The Authority be captured, only The Guardian appears to possess the ability to ultimately pronounce a sentence which would result in the True Death for the vampire.
Vampire monarchs also have a certain amount of persuasion over the matter, as seen in Season 4 when Bill Compton persuaded Nan to allow him to execute Eric. In cases involving less important Vampires however, it does not appear that the Monarch must receive any form of permission from the Authority. As seen in the case of the YouTube Vampire, whom Bill Compton was able to execute without even having to bring the case before the Authority.
Known Causes of the True Death
Meeting the sun - When exposed to sunlight vampires will begin to burn in a manner consistent with their age. Younger Vampires can endure prolonged exposure and still have a good chance to heal. They will however endure a significant amount of pain and their skin will get charred. Older Vampires are much more sensitive to sunlight, as seen with Godric who was completely incinerated within a few seconds of exposure.
Fire - Vampires can heal from pretty serious burns, but if they are exposed for too long, they will eventually die.
Exsanguination - When a Vampire is drained completely of their blood.
Decapitation - Vampires are unable to heal if their head is completely severed, as seen with Jorge Alonso.
Roman Zimojic being presented a ceremonial wooden stake by Salome
Staking - When a vampire's heart is completely penetrated with any sort of wood (Wooden bullets & stakes, pencils, etc.) the vampire is completely destroyed, and meets the True Death. There are two ways in which vampires die when exposed to this method. If a vampire is struck quickly and directly through their heart (as with wooden bullets), they will explode on impact like a balloon, spraying blood everywhere. When a vampire is pierced through the heart in a slower method, usually by staking, they dissolve and "implode." The rate at which the vampire dissolves after staking seems to be related to how the stake is inserted into the heart. When a vampire is staked slowly, red cracks will appear on their skin and grow deeper while their eyes turn blue. Staking appears to be the preferred method of execution for forms of Vampire Government, namely The Authority. A quick "ceremonial" type of performance is even used of presenting the ancient silver tipped wooden stake to The Guardian, which is used to carry out the execution.
Hepatitis V - When a vampire is infected with Hep V via sexually, ingestion, or injection they will weaken and die within 24-48 hours.
Colin - (He could meet the true death after leaving Pam/mentioned in season 5)
Authority Gate Guard - (He could survive an annihilation of The Vampire Authority/season 5)
Nigel Beckford - (He could have survived the annihilation of The Vampire Authority/season 5)[1]
Resurrection
When Sookie finds the jar with the remains of Talbot, she discovers that Russell hopes to resurrect his lover. However, she takes the ruins and destroys them before any attempt at resurrection is shown.
Bill post-resurrection
We see a real resurrection when Bill drinks the blood of Lilith. He begins to bleed from the eyes and mouth and then seems to be destroyed, leaving a pool of blood behind. He remained in this state only for a few moments before reforming covered in blood.
In the case of Bill rising again from the dead seems to be a disorienting experience because shortly after being reformed by his remains, Bill falls prey to a murderous rampage. He then massacres many of the remaining members of the Authority and destroys the entire complex.
Faerie Blood
Faerie blood does not save a vampire from True Death but it has several effects that change the usual process of dying. Vampires who have been staked experience True Death at a much slower pace as witnessed when Russell was staked by Eric or when Jason impaled Warlow. Russell even thought he was immune before his skin began to crack inevitably announcing his demise.
↑He was a nurse at a hospital in the maternity ward, instead of delivering babies he ate them, that was stated by Nora when she was in the cell next to him.
