目的 分析2012—2023年新疆维吾尔自治区克拉玛依市5岁以下儿童的死亡原因和变化趋势，为辖区政府制定相关政策和措施提供科学依据。方法 对2012—2023年克拉玛依市5岁以下儿童死亡监测资料进行分析，计算5岁以下儿童各年龄段死亡率，分析不同户籍、性别和年龄段儿童死亡率的差异，并分析死亡原因、顺位及变化趋势。结果 2012—2023年克拉玛依市5岁以下儿童死亡率、婴儿死亡率、新生儿平均死亡率分别为6.84‰、6.35‰、3.64‰，总体呈下降趋势，差异有统计学意义（均P<0.05）。5岁以下户籍儿童的各年龄段死亡率低于非户籍儿童，5岁以下女童各年龄段死亡率均较男童低。克拉玛依市5岁以下儿童前5位死因分别为早产/低出生体重、出生窒息、先天性心脏病、其他先天异常和肺炎。结论 克拉玛依市要进一步降低5岁以下儿童的死亡率，重点应放在对新生儿的健康管理（尤其是预防早产儿或低出生体重儿的发生）和非本市户籍儿童的管理上。

Objective To analyze the causes and trends of death of children under 5 in Karamay, Xinjiang Uyghur autonomous region from 2012 to 2023, so as to provide scientific evidence for policy making for local govermont. Methods The death monitoring data of children under 5 from 2012 to 2023 in Karamay were analyzed. The mortality rates of children under 5 in different age groups were calculated. The differences of child mortality rates in different registered residence, gender and age groups were analyzed, and the cause, sequence and trend of death were analyzed. Results From 2012 to 2023, the mortality rate of children under 5, infant mortality rate and neonatal mortality rate in Karamay were 6.84 ‰, 6.35 ‰ and 3.64 ‰, respectively, showing a downward trend in general, and the differences were statistically significant(P_all<0.05). The mortality rate of children under 5 in registered residence was lower than that in non registered residence, and the mortality rates of girls under 5 in all age groups were lower than those of boys. Top five causes of death of children under 5 in Karamay were premature delivery or low birth weight, birth asphyxia, congenital heart disease, other congenital abnormalities, and pneumonia. Conclusion To further reduce under-5 mortality in Karamay, priority should be given to enhancing neonatal health management-particularly the prevention of preterm birth and low birth weight-and to strenthening care for children.