The population-based death rate as an important indicator of health status has been widely used in injury research. Generally, the death rate from injury for males is about three times that for females. The importance of the various factors that contribute to this male-female discrepancy, however, has not been well understood. Using the innovative Decomposition Method, data from the Nationwide Personal Transportation Survey, the National Electronic Injury Surveillance System, and the National Center for Health Statistics were analyzed to explore the determinants of the male-female difference in death rates from bicycling injury. The results revealed that males have higher death rate from bicycling injury than females because they have a greater exposure rate and case fatality rate. When exposure measured by number of bicycle trips is taken into account, males are at slightly lower risk of injury than females. The relative contribution of case fatality, exposure, and risk to the 6.4-fold difference in death rates from bicycling injury between men and women is 53%, 51%, and -4%, respectively.