The Regional Infant and Child Mortality Review Committee serves 10 counties in southeastern South Dakota and aims to use its reviews to prevent future loss of life during childhood. In 2016, the Committee reviewed 25 deaths (compared to 32 cases in 2013, 25 in 2014, and 24 in 2015). In 2016, three deaths in the region were attributable to maltreatment. This is an outlier from previous years when typically one such tragedy occurs and reveals the fragility of young life in stressed and unstable home environments. In 2016, there was also an increase from recent years in accidental deaths that included three children who were not properly restrained as passengers or while driving. In 2016, five infants died during sleep compared to seven the previous year and four of these deaths occurred with risks present in the sleep environment. The Committee has not seen progress towards decreasing infant deaths during sleep in our region. In fact, their number may even be increasing. The report provides the Committee’s recommendations for community action that could prevent future deaths of infants and children.