Abstract: Objective To analyze the characteristics and patterns of dead cases in pre-hospital first aid in Wenzhou City, in order to provide a reference for improving the level of first aid and reducing the incidences of pre-hospital death. Methods Death cases which occurred in pre-hospital first aid by calling "120" from January to December 2010 in Wenzhou City were analyzed and summarized retrospectively. Results The mortality rate in pre-hospital first aid was 1.58%, with the ratio of male to female being 2.73:1. The mortality rate was the highest among the 30-39 age group. The major causes of pre-hospital death were sudden death,trauma, cardiovascular and cerebrovascular disease.The highest-risk time for pre-hospital death is 6:00-8:00 am every day.Compared with the Spring and Autumn quarters, the number of pre-hospital deaths were larger than in summer and winter quarters. Conclusion In consideration of the characteristics of pre-hospital death cases, medical staff should enhance their training levels, allocate medical resources rationally and implement publicity for high risk population, thus reducing the incidence of pre-hospital death.