BACKGROUND: In Alabama, little is known about the overall characteristics of job-related injuries. METHODS: We examined fatal occupational injuries that occurred in Jefferson County, Alabama, from 1990 through 1999 using files maintained by the Jefferson County Coroner/Medical Examiner Office. Mortality rates were calculated by sex, age, race, occupation, and industry. RESULTS: There were 186 fatal occupational injuries; 136 were unintentional. The overall fatality rate was 4.45 deaths per 100,000 worker-years. Mortality rates were higher among men than among women, and they increased with advancing age. The homicide rate was higher among black workers than among whites. Mining, manufacturing, and transportation were the industries with the highest fatal injury rates. Transportation-related jobs and manual labor were high-risk occupations. CONCLUSION: High-risk industries should consider worker-targeted injury prevention programs, and particular attention should be paid to elderly workers.