Mexican Juan Pablo de la Mora asked for help when he felt ill after crossing the line and died in hospital later, organisers said.
The first three in the men's marathon were Kenyan runners, with Elisha Chumo second and Hillary Kipchirchir third.
Ethiopia's Amare Shewarge Alene was first in the women's race followed by Kenyan Truphena Tarus and Mexican Maritza Arenas.
