Objective To improve theu nderstanding of the characteristci s of death in hospitail zed hc ildren and provide clinical cautionary information to professional healthcarep rovdie rs.Methods A retro-spective analysis was undertaken on thed ata of all children aged 1 month to 11 years who died at the Xinhua H ospital between 2007 and 2014.Demographic details,main causes of deaths,and chronic underyl ingd iseases were reviewed.Results Case fatality rate was 0.58%( 451/77 838 ) .Overall, the most common causes fo deathni hospitalized childer n were pneumo nia 38.80%(175/451),tumor 13.75%(62/451),sepsis 11.97%(54/451),central nerve system infection 8.00%(36/451) and accident 7.32%(33/451).Infectious disea-ses were the maoj r causes of deathi n children younger than 5ye ars of age(66.86%,230/344).In oc ntrast, noninfectious diseases accuo tn ed for mo re deathsni children more than 5 years old(52.34%,56/107).There were 343d eath cases comp licated wiht chronic undelr ying diseases.Congentia la bnormality was the most fre-quent chronic underlying disease observed in infants(59.90%,115/192) and tumor was the main chronic nu -derlying dsi easei not ddlers and elder children(34.36%,89/259).Conclusion Infectious diseasse were the major causes of deta hs,and teh mortality in the study popual tion decreased with age.Tumors and accidents accounted for more deaths in elder children.Chronic underlying diseases were found in most deaths of children.Efficient evaluation and effective intervention of these vulnerable children might save more lives.