Objective To analyze the death of children under 5 years old in Dalian from 2014 to 2018 and provide scientific evidence for further control and reduction of under-five mortality in Dalian.Methods The death data of children under 5 years old in Dalian from 2014 to 2018 were collected using the three-level child death report monitoring system centered on maternal and child health care institutions.The chi-square test was used to analyze the difference in death rate and composition ratio.The annual percent change（APC）was used to evaluate the annual trend of mortality

and the fitted linear slope of the geometric mean of mortality was t-tested.Results In2014-2018

the infant mortality and the under-five mortality in Dalian showed a downward trend（P<0.05）

with an APC of-6.01% and-5.16%

respectively

and the rate of decline in neonatal mortality and mortality of children aged 1-4 years was not significant（P>0.05）.The difference in under-five mortality rate among different quarters was statistically significant in 2016 only（P<0.05）.The top five causes of death in infants were:low birth weight caused by premature birth

other congenital anomalies

other neonatal diseases

congenital heart disease

and birth asphyxia.The composition ratio was 16.44%

13.79%

12.30%

11.26% and 10.69%

respectively.The top five causes accounted for 64.48%of total death.The top five causes for death in children aged1-4 years were:other tumors

traffic accidents

other nervous system diseases

accidental falls

and leukemia.The composition ratio was 16.46%

14.77%

11.81%

7.59%

and 7.17%

respectively.The top five causes accounted for 57.80% of total death.The top five causes of death in children under 5 years old were:low birth weight caused by premature birth

other congenital anomalies

congenital heart disease

other neonatal diseases

and birth asphyxia.The composition ratio was 12.92%

11.38%

10.12%

9.67%and 8.40%

respectively.The top five causes accounted for 52.49% of total death.Conclusion In recent years

the mortality rate of children under 5 years old in Dalian has been decreasing

but it is still necessary to pay attention to the monitoring of children′s quality of life

strengthen perinatal health care

prevent birth defects

pay attention to children′s safety education

and increase the propaganda and aids for congenital heart disease

so as to further reduce children mortality.