Injuries account for 75% of all deaths among American Indian and Alaska Native (AI/AN) children and youth, and AI/ANs have an overall injury-related death rate that is twice the U.S. rate for all racial/ethnic populations. However, rate disparities vary by area and by cause. To help focus prevention efforts, CDC analyzed injury mortality data by Indian Health Service (IHS) administrative area and by race/ethnicity. This report summarizes the results of these analyses, which indicate that although death rates for some causes (e.g. drowning and fire) have shown substantial improvement over time, rates for other causes have increased or remained unchanged (e.g., homicide and suicide, respectively). Prevention strategies should focus on the leading causes of injury-related death in each AI/AN community, such as motor-vehicle crashes, suicides, and violence.