Diabetes is a chronic disease with a U.S. prevalence of 18 cases per 10,000 youths aged <20 years. With proper management and access to care, morbidity and mortality from diabetes are preventable, particularly in the pediatric population. Although diabetes is more common among non-Hispanic white youths, some studies report higher death rates among racial/ethnic minorities and among those in lower socioeconomic strata. In 2004, age-adjusted diabetes death rates for black persons in the United States were approximately twice those for white persons. However, no recent studies on racial disparities that focus specifically on the pediatric population have been conducted. To assess racial disparities in diabetes mortality among youths, CDC analyzed data on deaths with an underlying cause of diabetes among persons aged 1-19 years for the period 1979-2004. This report summarizes the results of that analysis, which determined that, during 1979-2004, diabetes death rates for black youths were approximately twice those for white youths. During 2003-2004, the annual average diabetes death rate per 1 million youths was 2.46 for black youths and 0.91 for white youths. Further study is needed to discern the specific reasons for increased diabetes mortality in black youths. Better identification and management of the disease among youths, especially among black youths, might help decrease racial disparities and prevent deaths from diabetes.