The NT Child Deaths Review and Prevention Committee's latest annual report reveals there were 38 child deaths in the NT last year.
More than three quarters of those were Indigenous, and almost two thirds were from outside the Greater Darwin area. 60 per cent were infants.
Attorney-General Natasha Fyles tabled the report in parliament on Wednesday, saying the child mortality rate had dropped slightly in the past three years, but any death is still tragic for families.
"Those young children sadly pass away from disease, disability, from accidents as well, but we need to make sure that the system isn't failing them," Ms Fyles said.
During the five-year period up to 2015, the number of deaths of Aboriginal children was substantially greater than their non-indigenous counterparts.
"There was a total of 180 deaths of Aboriginal children, or 74.4 per cent of all child deaths, which is much greater than the proportion of all of Aboriginal children (41 per cent) in the total NT population for these age groups," the report said.
The number of child deaths in remote regions (71 per cent) was also disproportionately higher than deaths in the Greater Darwin region (29 per cent) despite a similar population in both areas.
The majority of child deaths in this period occurred during infancy.
There were 684 deaths per 100,000 infants in the NT, comprising rates of 1479 and 284 per 100,000 infants, for Aboriginal and non-Aboriginal infants respectively.
Of the 227 child deaths during this period, the most common causes were considered preventable and 'external'.
During that same five-year period, eight children died while in state care.
"Those deaths are automatically referred to the coroner for that extra level of scrutiny. It's important that [any] recommendations are then listened to by government," she added.
One death is yet to go to inquest, but of the other seven deaths investigated by the coroner no adverse findings were related to the quality of care.