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From November 22 to December 9, 1943, Roosevelt flew to the middle east, where he made stops in Cairo, Tehran, Tunis and also visited American troops on Malta and in Italy. He spent November 22–26, in Cairo where he attended the First Cairo Conference with British Prime Minister Winston Churchill and Chinese leader Chiang Kai-shek, before flying to Tehran on November 27. He remained in Tehran until December 2nd, during which time he attended the Tehran Conference with Soviet Premier Joseph Stalin and with Prime Minister Winston Churchill. The Tehran conference followed the Anglo-Soviet Invasion of Iran. It was held in the Soviet Union's embassy in Tehran, Iran. It was the first of the World War II conferences of the "Big Three" Allied leaders (the Soviet Union, the United States, and Great Britain). Each of the three leaders arrived at the conference with differing objectives, but the main outcome of the Tehran Conference was the Western Allies' commitment to open a second front against Nazi Germany. The conference also addressed the Allies' relations with Turkey and Iran, operations in Yugoslavia and against Japan, and the began planning of what a post-war world would look like. A protocol signed at the conference pledged the Big Three to recognize Iran's independence.
After the conference Roosevelt traveled back to Cairo where he remained from December 2–7. There he attended the Second Cairo Conference with Churchill and Turkish President İsmet İnönü. He next travelled to Tunis, in Tunisia, where he stayed from December 7–9, 1943. He conferred with General Dwight Eisenhower, commander of the Allied forces. In the course of that visit, he made two stops on December 8th, one at Valletta in Malta, and the other at Castelvetrano in Italy. There he visited Allied military installations. On December 9th he left to return home to Washington.
The next meeting of the "Big Three" took place in February of 1945, just two months before Roosevelt's death in April of 1945. Roosevelt met with Churchill on February 2, 1945 at Floriana on Malta. The next day he flew to Yalta, in the Soviet Union where he attended Yalta Conference with Stalin and Churchill. This conference was held from February 4 to 11 and the three leaders discussed Europe's postwar reorganization. The conference convened in the Livadia Palace near Yalta in the Soviet province of Crimea. The goal of the conference was to shape a post-war peace that represented a collective security order and a plan to give self-determination to the liberated peoples of post-Nazi Europe.The meeting was intended mainly to discuss the re-establishment of the nations of war-torn Europe. Within a few years, with the Cold War dividing the continent, Yalta became a subject of intense controversy. To a degree, it has remained controversial.
Yalta was followed by the Potsdam Conference in July 1945, but FDR would not attend that conference. The President left the Yalta Conference on February 12, 1945, flew to Egypt and boarded the USS Quincy operating on the Great Bitter Lake near the Suez Canal. Aboard Quincy the next day, he met with King Farouk I of Egypt, and Emperor Haile Selassie of Ethiopia. On February 14, he held a historic meeting with King Abdulaziz, the founder of Saudi Arabia, a meeting that laid the groundwork for modern U.S.–Saudi relations. After a final meeting between Roosevelt and Prime Minister Winston Churchill, the Quincy steamed for Algiers, arriving February 18, at which time Roosevelt conferred with American ambassadors to Britain, France and Italy about what had taken place at Yalta.
Roosevelt's health was not good on this trip. At Yalta, Lord Moran (Winston Churchill's physician) commented on Roosevelt's ill health, saying that he was a dying man. When Roosevelt returned to the United States, he addressed Congress on March 1 about the Yalta Conference. Many people commented on how shocked they were about Roosevelt's appearance. He looked, thin, frail, and much older than his 63 years. He spoke while seated in the well of the House, a rare acknowledgement of his physical incapacity. Roosevelt opened his speech by saying, "I hope that you will pardon me for this unusual posture of sitting down during the presentation of what I want to say, but it makes it a lot easier for me not to have to carry about ten pounds of steel around on the bottom of my legs."
In March of 1945, Roosevelt sent strongly worded messages to Stalin accusing him of breaking his Yalta commitments over Poland, Germany, prisoners of war and other issues. At this point Roosevelt was increasingly overworked and fatigued. His daughter Anna had moved in to provide her father with support. Anna had also arranged for Roosevelt to meet with his former mistress, the now widowed Lucy Mercer Rutherfurd. On March 29, 1945, Roosevelt went to the Little White House at Warm Springs, Georgia, to rest before his anticipated appearance at the founding conference of the United Nations. On the afternoon of April 12, Roosevelt said, "I have a terrific pain in the back of my head." He then slumped forward in his chair, unconscious, and was carried into his bedroom. The president's attending cardiologist, Dr. Howard Bruenn, diagnosed the medical emergency as a massive cerebral hemorrhage. At 3:35 p.m. that day, Roosevelt died. When news of his death broke, an editorial by The New York Times declared, "Men will thank God on their knees a hundred years from now that Franklin D. Roosevelt was in the White House".
At the time he collapsed, Roosevelt had been sitting for a portrait painting by the artist Elizabeth Shoumatoff; the painting would later become known as the famous Unfinished Portrait of FDR.