Objective To understand the mortality of different age in children under 5 years old in Hainan province, make reasonable intervention measures and provide the basis for reducing child mortality. Method The data of all deaths of children under 5 years old in Hainan province from 2009 to 2013 were analyzed. Results The proportion of children died at home was 49.04%.The proportion of children without treatment before death was 4.97%.Rural children under 5 years old without treatment before death was significantly higher than the urban children, "too late to the hospital" accounted for the highest proportion (52.53%) among untreated causes, followed by "economic difficulties" (24.19%). Conclusion Government departments can reduce the mortality rate of the children under 5 years old in rural care service through strengthening pregnancy care service and the construction of rural medical service capacity.