During 2003-2013, the U.S. oil and gas extraction industry experienced unprecedented growth, doubling the size of its workforce and increasing the number of drilling rigs by 71%. To describe fatal events among oil and gas workers during this period, CDC analyzed data from the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI), a comprehensive database of fatal work injuries. During 2003-2013, the number of work-related fatalities in the oil and gas extraction industry increased 27.6%, with a total of 1,189 deaths; however, the annual occupational fatality rate significantly decreased 36.3% (p<0.05) during this 11-year period. Two-thirds of all worker fatalities were attributed to transportation incidents (479, [40.3%]) and contact with objects/equipment (308 [25.9%]). More than 50% of persons fatally injured were employed by companies that service wells (615 [51.7%]). It is important for employers to consider measures such as land transportation safety policies and engineering controls (e.g., automated technologies) that would address these leading causes of death and reduce workers' exposure to hazards.