Injury deaths in Ohio children aged 1 to 16 years account for less than 0.5% of all deaths in the state but 6% of all years of life lost before age 65 years. In this study, injury mortality rates were calculated by sex for three age groups (1 to 5, 6 to 11, and 12 to 16 years) and three population groups (metropolitan white, metropolitan nonwhite, and nonmetropolitan). The 15 metropolitan counties were those with a central city of at least a population of 50,000, containing 60% of the state's population. Fire is the leading cause of injury mortality for metropolitan children aged 1 to 5 years, while motor vehicle injuries and drowning are the leading causes for nonmetropolitan children in this age group. Fire is also the leading cause for metropolitan nonwhite children aged 6 to 11 years, while motor vehicle injuries are the leading cause for nonmetropolitan children, and pedestrian injuries are the leading cause for metropolitan white children. For nonmetropolitan and metropolitan white children aged 12 to 16 years, motor vehicle injuries are the leading cause, while for metropolitan nonwhite children homicide is the leading cause. Excess deaths for each cause were estimated by calculating the number of deaths expected for each age group if the rate experienced by the second-lowest population race group had applied to the whole population in that age group, and comparing this with the observed number. Using this approach, highest priority would be placed on prevention of motor vehicle deaths in 12- to 16-year-old nonmetropolitan and metropolitan white children, of fire deaths in metropolitan nonwhite children aged 1 to 11 years, and of drowning deaths in boys aged 12 to 16 years in all three population groups.