Abstract: ObjectiveTo analyze the trends of mortality rate and rank of death cause among children under 5 in Qingdao from 2011 to 2020.MethodsDeath surveillance data among children under 5 in Qingdao from 2011 to 2020 were obtained from maternal and child health information system. Under 5 mortality rate(U5MR),proportion of death, causes of death and factors related to these were analyzed retrospectively.ResultsU5MR in Qingdao showed a general downtrend from 2011 to 2020(χ_trend²= 78. 566,P< 0. 05).U5MR of urban children was lower than that of rural children, and that difference between 2019 and 2020 was statistically significant(χ²= 6. 164,P< 0. 05;χ²= 8. 254,P< 0. 05). The proportion of infants death showed a descending trend, while the proportion of death aged 1-4 years old showed an ascending trend(χ_trend²= 30. 079,P< 0. 05) from 2011 to 2020. The main causes of death under 5 were preterm birth or low birth weight, birth asphyxia, congenital heart disease, other congenital abnormalities and pneumonia. Among all death, U5MR caused by accidental asphyxia, traffic accident and other tumor showed an ascending trend.ConclusionU5MR in Qingdao showed a general downtrend from 2011 to 2020. To further reduce U5MR, it is effective to achieve rational allocation of health service resources, construction of rescue centers for high-risk pregnant women and newborn, and strengthening birth defects prevention and control.