During 2000During -2009 Gulf of Mexico (GoM) fishers were killed (23% of the US total) while working in the shrimp, finfish, oyster, clam, and crab fisheries. The purpose of this literature review is to identify injury-related risk factors to better assess the frequency and severity of injuries experienced by fish harvesters in the GoM. Methods: The method of this study is a comprehensive narrative literature review of findings useful for the prevention of fatal and non-fatal injuries among GoM fish harvesters published since 2005. Search engine terms were used to identify relevant literature that included fatalities, injuries, fatigue, and several other terms in combination (e.g., string search with "fishing"). Results: We reviewed 48 articles; the most common cause of fish harvester deaths in the GoM is falls overboard with scant use of personal flotation devices and vessel disasters in which flooding and collision were the most lethal. The root cause of errors resulting in many disasters may have been operator fatigue, but fatigue is also an adverse health effect resulting from working conditions. Non-fatal injuries arise from multiple sources that include working with gears, slips and trips, struck-by or against objects, machine or line entanglements, and falls. Conclusion: Principal risk factors are a lack of sleep aboard fishing vessels, vessel flooding and collisions, poor weather, slips on deck, contact with gear, not wearing personal flotation devices, poor swimming ability, and fishing alone on a vessel or the deck.