A population-based occupational fatality surveillance system was used to identify 452 work-related fatalities in Kentucky over a 3-year period. Three hundred eighty-six workers less than 65 years old were included in this analysis of potentially productive years of life lost (PPYLL). A total of 9,275 years of potentially productive life were lost due to these occupational fatalities, costing the state economy $148 million in lost wages. Most of this loss (70%) was in the industries of transportation/communication/public utilities, manufacturing, mining and construction. The transportation/communication/public utilities division alone accounted for 21.4% of the total lost earnings. The agricultural/forestry/fishing division exceeded all others in potentially productive years of life lost. However, because of its lower mean income and older ages at death, that division ranked fifth in lost earnings. This article demonstrates that prevention resources should be directed at the agriculture, transportation, and logging industries, and to the prevention of fatalities caused by tractors, motor vehicle crashes, and falling objects, to be most effective in reducing the enormous burden of occupational fatalities.