Abstract: Objective To analyze the characteristics of changes in the deaths of injuries among children under 5 years old between China and Kazakhstan from 2000 to 2015, in order to promote the common prevention of child injury in the countries along the belt and road initiative. Methods The data of injuries mortality among children under 5 years old from 2000 to 2015 were got from global health observational database on the net of world health organization. The dynamic distribution of the injuries mortality were described and analyzed. Results During the past 16 years, the injuries mortality rates of children under 5 years old in China and Kazakhstan both showed a downward trend. The average rate of decline was 6.14% annually in China and it was lower than that of global level after 2010; the average rate decreased by 5.14% annually in Kazakhstan and it was consistently lower than that of global level. Traffic accidents and drowning were both among the top three causes of death in injuries for children under 5 years old in both countries. The death rates of these two types of injuries in China had declined significantly over the past 16 years. The proportion of mechanical injuries increased while the proportion of violent injuries decreased in both countries (all P<0.05). Injuries mortality rates of boys was higher than that of girls among children under 5 years old (all P<0.05), but there was no significant difference in the degree of the rate of decline in injury deaths within the same stage of years in both countries (all P>0.05). Conclusions In the past 16 years, the effectiveness of prevention and control of injuries among children under 5 years old were more remarkable in China and Kazakhstan compared with the global average level. The prevention and control of the injury mortality between boys and girls reflected the fairness of health services in the two countries. China's prevention and control measures for traffic accidents and drowning injuries are worth learning. Further prevention and control are needed to focus on the key issues of major types of injury in both countries.