During 2000-2006, commercial fishing was one of the most dangerous occupations in the United States, with an average annual fatality rate of 115 deaths per 100,000 fishermen. By contrast, the average annual occupational fatality rate among all U.S. workers during the same period was four deaths per 100,000 workers. During the 1990s, safety interventions in Alaska fisheries were followed by declines in that state’s commercial fishing fatality rates. To assess the need for similar safety improvements in the other three Pacific Coast states, CDC analyzed data on commercial fishing fatalities from California, Oregon, and Washington during 2000-2006. The results of that analysis indicated that the three states combined had an average annual commercial fishing fatality rate of 238 deaths per 100,000 full-time equivalent (FTE) fishermen, approximately double the fishing fatality rate nationwide during the same period. CDC also determined that safety equipment (e.g., immersion suits or life rafts) had not been used adequately in these fatal events, and that the Northwest Dungeness crab fishery had the highest fatality rate of any fishery located off the coasts of California, Oregon, and Washington. To reduce fatalities among the Pacific Coast commercial fishermen at greatest risk, additional prevention measures tailored to the Northwest Dungeness crab fishery should be considered.