Methods: Retrospective descriptive study of cases series. Results: There were 169 death cases of HFMD in nationwide diagnosed clinically according to Health ministry national guidelines with or without throat or rectal swab PCR positive for EV / EV71, mean age of 27.3 months, youngest 8.5 months, oldest 13 years. Analysis showed that death related factors included misdiagnosis, wrong grade classification, inappropriate management, unsuitable followup, unsafe patient transportation, lack of medical instruments and medication as well.