Abstract： Objective To investigate the causes of rapid death after rescue among patients suffering crush injury after Wenchuan earthquake. Method A retrospective analysis of the medical records of 417 earthquake victims who remedied and transferred by our medical team was made. All patients were salvaged at scene according to the situation at that time and severe patients were transferred to undamaged peripheral general hospitals for continued treatment. Results A total of 417 patients (355 adults and 62 children) with earthquake related injuries and illness were admitted to our medical team. The mean age was (37± 9.6) years. There were 117 crush injury patients (79 male and 38 female) among those patients. The mortality of crush injury was 11.1% (13/117). Among the dead cases, five died of severe primary injury and the other 8 patients with sudden rapid death within 1 h after removal of compressive forces. Conclusions Hyperkalemia and its associated cardiotoxicity were the most common cause of rapid deaths after rescue among patients suffering crush injury after earthquake. Effective treatment of crush injury patients remains one of the most important measures in decreasing earthquake-related death rate.