Although diabetes mellitus most often is diagnosed in adulthood, it remains one of the most common serious chronic diseases of childhood. Youths with diabetes are at risk for diabetes-related mortality because of acute complications that can result from the condition, including diabetic ketoacidosis and hypoglycemia. In the United States in 2010, an estimated 215,000 persons aged ≤ 19 years had diagnosed diabetes. Medical care for diabetes has improved considerably in recent decades, leading to improved survival rates. However, recent trends in diabetes death rates among youths aged <10 years and 10-19 years in the United States have not been reported. To assess these trends, CDC analyzed data from the National Vital Statistics System for deaths in the United States with diabetes listed as the underlying cause during 1968-2009. This report highlights the results of that analysis, which found that diabetes-related mortality decreased 61%, from an annual rate of 2.69 per million for the period 1968-1969 to a rate of 1.05 per million in 2008-2009. The percentage decrease was greater among youths aged <10 years (78%) than among youths aged 10-19 years (52%). These findings demonstrate improvements in diabetes mortality among youths but also indicate a need for continued improvement in diabetes diagnosis and care.