The aim of this study is to describe the characteristics of fatal drowning in Guangdong Province during the period 2004-2005. Twelve areas were randomly chosen by stratified cluster sampling, and a retrospective cross-sectional survey was conducted in 2006 to collect death cases during the 2004-2005 period. Causes of death relating to drowning were coded according to International Classification of Diseases, the tenth version. During 2004-2005, 849 unintentional drowning deaths occurred, representing a drowning rate of 5.6/100,000 per year. The rate was higher in rural areas (6.4/100,000) than in city (3.7/100,000), and the rate ratio of male to female was 1.5. The elderly aged 80 years and over and children aged 5-9 years had higher mortalities among all age groups, representing rates of 28.8 and 11.0 per 100,000 person years. For children aged 5-9 years, deaths from drowning accounted for the highest proportion (62.5%) of all injury deaths. The most common site of drowning was natural bodies of water (60.8%), and summer was the highest risk season for drowning. The results suggest drowning is an important public health problem, and it primarily threatens children in Guangdong province. Drowning intervention programs should be a health priority in Guangdong province.