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Knowledge about the environmental impacts of various transportation modes is important to better understand tradeoffs that may be involved in policy options that affect different transportation modes in different ways. This paper reviews the literature on human health impacts attributed to various transportation modes, focusing on premature mortality, in order to carry out a comparative analysis of the modes. We find that the risks of premature death attributable to air pollution from rail, shipping, and aviation emissions are typically larger than the accident-related fatalities of these modes; for road transportation air pollution related premature mortality risks are similar in magnitude to the number of fatalities from accidents. Among the modes considered, road transportation has the largest impact on air quality health risks. Within road transportation, passenger and heavy road vehicles are estimated to be responsible for almost equal shares of premature mortality due to air pollution. Road is followed by ocean shipping, rail, and aviation, respectively, for air quality related total health impacts. We also normalize these health risks with respect to the service delivered by each mode to account for the differences in the levels of activity among different modes. In this case, road vehicles are found to have the largest impact per unit of activity (expressed as equivalent ton-miles), with aviation ranked second on a per ton-mile basis. Rail transportation is the most environmentally friendly mode on a per ton-mile basis, followed closely by shipping. Despite rail’s relatively low air quality related mortality risks per ton-mile as a transportation mode, passenger rail …