Abstract: Objective To analyze epidemiological characteristics and risk factors of the death cases of hand foot and mouth disease (HFMD) in Ningxia. Methods Descriptive epidemiological analysis was conducted on the data of the HFMD death cases, including their cases survey results and clinical symptoms, reported through national disease reporting information system. Results Five deaths of HFMD occurred sporadically in rural area from 2008 to 2010, including 3 girls and 2 boys aged 12 months to 42 months (median: 18 months). Three deaths occurred during June-July, and 2 occurred in September. The fever of the death cases lasted for 2.4 days averagely, the clinical symptom also included typical rash on hands, feet, mouths, buttocks and oral cavity mucosa. The interval between the onset and medical care seeking was 2.2 days averagely, and the interval between the severe symptom onset and death was 4 hours averagely. The complicated neurogenic pulmonary edema and respiratory/cardia failure were the major death causes. All the death cases were detected to be EV71 positive. Among 9 close contacts (14 years old) of the death cases, four became ill, the EV71 positive rate of their stool samples was 75%. Conclusion All the deaths were caused by EV71 infection, The incidence of HFMD death could be reduced by increasing children parents awareness of seeking medical care when their chilldren become ill and improving the diagnosis ability of clinicians for HFMD.