Abstract: Objective To analyze the disease burden and its changes of adolescents in Jiangsu Province in 2003 and 2016, and to provide scientific basis for the health promotion of adolescents. Methods Death data of 2013 and 2016 were collected from The Third Death Retrospective Survey and The Death Registration System in Jiangsu, respectively. Indicators of disease burden including mortality, years of life lost (YLL) etc. were calculated. Results In 2003 and 2016, the number of youth deaths in Jiangsu Province was 5 025 and 2 222, respectively, with age-standardized mortality rate decreased by 16.04%. Corresponding YLL was 357 461 person-years and 156 932 person-years respectively, and the age-standardized YLL rate decreased by 36.36%. In 2016, the top five causes of death among adolescents in Jiangsu Province were road injuries, drowning, suicide and its sequelae, leukemia, accidental fall, among which, accidental fall rose from the 9th in 2003 to the 5th in 2016. We also found that the proportion of youth deaths of chronic non-communicable diseases has rapidly increased, especially for female adolescents, the proportion has exceeded injury both in 2003 and 2016. The causes of death varied in different age groups, the first leading cause of deaths was drowning and road injuries in the age group of 10-14 and 15-24, respectively. Conclusions Compared with 2003, the disease burden of adolescents in Jiangsu Province has decreased significantly in 2016. While for health promotion among adolescents, relevant measures should be taken according to the disease burden among different genders and ages.