Objective: To examine the trends in injury mortality in Taiwan by sex, age, and cause between 1986 and 2007. Methods: Analysis of routine mortality data from the official publications of vital statistics from 1986 to 2007 to determine trends by sex and cause of death. Linear regression was used to test the trends. Results: A total of 310,123 people in Taiwan died as a result of injury between 1986 and 2007. Total and unintentional injury mortality rate were declined (24% and 43.5%), but intentional injury mortality rate was increased (70%). Both intentional and unintentional injury mortality rate of male were higher than female. Injury mortality rate was increased by age, but totalage injury mortality rates declined. Motor vehicle injury was the major unintentional injury death cause in Taiwan, followed by drowning. Motor vehicle and drowning mortality rate were declined. Fall injury mortality rate did not significantly change in the study period, and took the place of drowning since 1996. Suicide mortality rate significantly increased in the study period. Homicide mortality rate slightly declined, but increased in the 1-4-year age group. Conclusions: Total injury mortality rate declined, but motor vehicle injury, drowning and fall injury were three unintentional injuries to concern. Suicide and child homicide are also key points to prevent in the future.