The study found a significantly higher rate of death among the children in the maltreatment group. Maltreated children had approximately twice the risk of death before age 18 (0.51 percent) compared to the matched nonmaltreatment group (0.27 percent). A similar difference was found when deaths among any children in the household were compared between groups. The majority of deaths among children in the maltreatment group were categorized as preventable, i.e., they were due to accidents or maltreatment rather than serious health conditions. Most of the maltreated children who later died had prior reports that included neglect. This indicates the need to consider how neglect may pose a serious risk to a young child apart from whether or not a case is substantiated or resulted in injury at the time of the report. Consistent with general studies of child death and child maltreatment fatalities, younger children were at greater risk of death than older children. This suggests that interventions should give priority to families with young children. This article describes some types of family intervention likely to be effective in preventing childhood deaths. Data were obtained from a longitudinal study of services and outcomes for poor children in a major midwestern metropolitan region. All of the families were receiving income maintenance during the sampling period or within 24 months prior to the sampling period (1993-94). The study involved 7,438 children (3,719 in each group). All children were 7 years old or younger at the beginning of the study. Cases were tracked through annual dated administrative data records over 7.5 years, until time of death, or age 18. 2 tables and 53 references