Abstract: Objective To analyze under-5 child mortality and causes of death in Debao County,Guangxi 2016-2019 so as to provide scientific evidence for strengthening maternal and child health care. Methods Death monitoring data of children under 5 in Debao County 2016-2019 were collected,and incidence of death among children under 5,cause of death and pre-death condition were analyzed. Results Under-5 child mortality,infant mortality,and neonatal mortality in Debao County 2016-2019 were 3. 91‰,3. 09‰ and 2. 19‰,respectively. The percentage of infant deaths and neonatal deaths was 78. 9% and 56. 1% in all deaths among children under 5. The main causes of death among children under 5 included birth asphyxia,accident,premature birth or low birth weight,congenital heart disease and other birth defects,and their proportions were 19. 3%,17. 5%,12. 3%,7. 0% and 7. 0%,respectively. 24. 6% of deaths among children under 5 did not receive medical care. Conclusion Under-5 child mortality in Debao County is at a relatively low level. Reducing neonatal and infant mortality is the key priority for reducing deaths of children under 5 years. Prevention of birth asphyxia,accident,premature birth and low birth weight should be strengthened to further reduce Under-5 child mortality.