OBJECTIVES This study intends to determine if there is increased mortality for different causes among workers with permanent lower limb occupational disability. METHODS We collected all cases of permanent occupational disability from the database of compensation claim of Bureau of Labor Insurance between 1986 and 2006, which were linked with the national mortality registry to obtain the person-years at risk for different calendar periods. The standardized mortality ratios (SMR) for workers with permanent disability of upper and lower limbs were calculated to estimate the risk of mortality due to different causes in comparison with the general population of Taiwan. The software package of LTAS established by the National Institute of Occupational Safety and Health of the United States was employed for the above calculation. RESULTS We found significantly higher SMR in the following causes of death for workers sustained a permanent occupational disability : Gastrointestinal cancers (SMR=1.28, 95% confidence interval (CI)=1.02-1.59), benign tumor(SMR=7.38, 95% CI=3.19-14.54), diabetes mellitus (SMR=2.55, 95% CI=1.92-3.31), hypertension and stroke (SMR=1.42, 95% CI=1.06-1.86), suicide (SMR=1.92, 95% CI=1.19-2.93), injury (SMR=1.88, 95% CI=1.22-2.78), respiratory diseases (SMR=2.09, 95% CI=1.54-2.78), the digestive system diseases (SMR=1.36, 95% CI=1.02-1.77), and chronic kidney diseases (SMR=2.48, 95% CI=1.47-3.92). Workers suffering from permanent disability of upper limbs only showed an increased SMR for digestive system. CONCLUSIONS Workers with permanent lower limb occupational disability have higher risks of digestive cancer, injury, suicides, diabetes, and vascular diseases, which might be related to a general lack of exercise and should be considered in the process of rehabilitation and/or health promotion for these populations.