Two hundred thirty-five work-related deaths occurred in the construction industry in a new economic development area in eastern China between 1991 and 1997. These fatalities represented 55% of all occupational deaths. The average annual mortality rate was 51.5 per 100,000 construction workers. Falls were the leading cause of death (46.4%). Falls, collisions, struck by/against something, electrocutions, and excavation cave-ins were the main fatality antecedents, accounting for nearly 93.6% of all fatalities. The most common antecedents for incidents with multiple fatalities were falls, crane-related events, poisoning, and fire. These categories of antecedents were similar to those encountered in the construction industry in the United States. These data suggest that organizations need to focus on these event types when planning their prevention activities. Moreover, improved surveillance systems including computerized databases with narrative descriptions of injury events, antecedent factors, and person-time at-risk data are needed to target interventions more precisely.