The aim of the study was to analyse mortality and morbidity from external causes among Lithuanian children and adolescents. Methods. Information on deaths from major external causes during the period of 1988-2000 for Lithuanian children and adolescents aged 0-19 was obtained from the Department of Statistics. Information on the number of admissions to health care institutions due to injuries for children aged 0-14 years was gathered from Lithuanian Health Information Center. International comparisons were performed using data from the WHO/Europe Health for All Database. Mortality rates were age-standardized using the European standard, and analysed by sex, age, and place of residence. Years of life lost due to external causes were calculated. Mortality and morbidity trends were explored using the regression analysis. Results. External causes were the most common causes of death among Lithuanian children and adolescents aged up to 19 years, accounting for 36.5% of overall mortality during the period of 1988-2000. Children or adolescents lost approximately 330,000 (23.7 per 1,000 population) years of life due to external causes in 1988-2000, or every dead child or adolescent lost, on the average, close to 60 years of life. Age-standardized mortality from external causes of Lithuanian children and adolescents was 40.1 per 100 000 population in 1988-2000. Considerable inequalities in mortality by sex, age, and place of residence were disclosed, pointing out boys, children under one year of age, adolescents aged 15-19 years, and residents of rural areas as the most vulnerable groups. Throughout the study period mortality from external causes was decreasing, while the number of admissions to health care institutions and hospital discharges due to injuries was increasing. Despite a recent decline, mortality from external causes among children and adolescents remains at extremely high level in Lithuania as compared to other countries of Europe. Conclusions. High mortality rates due to external causes, and an increasing number of non-fatal injuries among Lithuanian children and adolescents demonstrate the great need for a definite, well-coordinated, and competent injury prevention strategy.