To estimate all cause mortality among children, adolescents, and youths aged 5-24 years for 200 countries and areas from 1990 to 2024, to assess mortality levels and trends, and to identify which regions and countries require the greatest investment. Progress in reducing mortality in people aged 5-24 years has been uneven and has slowed. Urgent, context specific investments—particularly in high mortality regions—are needed to reduce preventable deaths and strengthen mortality monitoring data systems.