Injury is recognised internationally as the major threat to adolescent health. The purpose of this study was to describe the epidemiology of adolescent fatal injury in New Zealand, and to examine opportunities for prevention. National mortality data were searched to identify all 15-19 year-olds, who died from injuries in the period 1986-1995. Leading causes of injury were reviewed in light of known risk factors, injury mortality rates in other industrialised countries, and available prevention strategies. The results showed that injury accounted for 2,095 deaths (72.8 per 100,000 person years). Males comprised 77% of victims (110.6 per 100,000 person years), and there was a three-fold increase in mortality from age 15 (35.3 per 100,000 person years) to 19 years (106.4 per 100,000 person years). The leading causes of death were road traffic crashes (42.6 per 100,000 person years), suicide (16.4 per 100,000 person years), and unintentional drowning (3.6 per 100,000 person years). The Graduated Driver Licensing System addresses a range of risk factors for adolescent road traffic crashes. Despite inadequate enforcement, early indications are that it has yielded modest reductions in injury. Hazardous drinking is implicated in the high rates of road traffic crashes and drownings, and given recent liberalization of supply-side policies, proactive identification of hazardous drinkers followed by brief intervention holds promise as a prevention measure. Suicide accounts for an increasing rate of adolescent deaths in New Zealand. The effect of national policies to address a range of suicide risk factors remains to be fully evaluated.