This study evaluated proportionate mortality patterns among all male construction workers in North Carolina who resided and died in North Carolina during the period 1988-1994. Proportionate Mortality Ratios (PMRs) and Proportionate Cancer Mortality Ratios (PCMRs) compared the number of deaths among male construction workers with the number of deaths expected based on the gender, race, and cause-specific mortality experience of the entire North Carolina population by five-year age groups for the same years of study. PMRs based on United States death rates also were calculated. Among all male construction workers, significantly elevated mortality was observed for several causes possibly related to work including malignant neoplasms of buccal cavity (PMR = 143), pharynx (PMR = 134), and lung (PMR = 113), pneumoconiosis (PMR = 111), transportation accidents (PMR = 106), and accidental falls (PMR = 132). Elevated mortality also was observed for causes more related to lifestyle and non-occupational factors including alcoholism (PMR = 145), cirrhosis of the liver (PMR = 129), accidental poisoning (PMR = 136), and homicide (PMR = 141). Patterns of elevated mortality for Whites and Black men were similar and PCMR mortality patterns for Blacks and Whites combined were similar to PMRs. Construction workers were at significantly increased risk for deaths resulting from falls from ladders or scaffolds, falls from or out of buildings or structures, and electrocutions. Construction trades found to have statistically elevated cancer risks include laborers and roofers (buccal cavity), painters (pharynx), laborers (peritoneum), and carpenters, painters, brick masons, and operating engineers (lung). These data are consistent with other reports demonstrating excess mortality from asbestos-related diseases (pneumoconiosis, lung cancer, and mesothelioma) among construction workers. Dry-wall workers and laborers were found to have a statistically elevated risk of death as a result of respiratory tuberculosis.