Commercial fishing is one of the most dangerous occupations in the United States.1 During 1992-2008, an annual average of 58 reported deaths occurred (128 deaths per 100,000 workers),1 compared with an average of 5,894 deaths (four per 100,000 workers) among all U.S. workers . During the 1990s, safety interventions addressing specific hazards identified in Alaska resulted in a significant decline in the state's commercial fishing fatality rate.2 During 2007-2010, CDC expanded surveillance of commercial fishing fatalities to the rest of the country's fishing areas. To review the hazards and risk factors for occupational mortality in the U.S. commercial fishing industry, and to explore how hazards and risk factors differ among fisheries and locations, CDC collected and analyzed data on each fatality reported during 2000-2009. This report summarizes the results, which showed that, among the 504 U.S. commercial fishing deaths, the majority occurred after a vessel disaster (261 deaths, 52%) or a fall overboard (155 deaths, 31%). By region, 133 (26%) deaths occurred off the coast of Alaska, 124 (25%) in the Northeast, 116 (23%) in the Gulf of Mexico, 83 (16%) off the West Coast, and 41 (8%) in the Mid- and South Atlantic. Type of fishing was known in 478 deaths; shellfish (226, 47%) was the most common, followed by groundfish (144, 30%) and pelagic fish (97, 20%). To reduce fatalities in this industry, additional prevention measures tailored to specific high-risk fisheries and focusing on prevention of vessel disasters and falls overboard are needed.