Census of Fatal Occupational Injuries data identify six states within or near the Appalachian mountain range that have the highest rates of agricultural tractor overturn deaths within the United States. Demographic and economic data that characterize farms in these six states were compiled from U.S. Department of Agriculture (USDA) 2002 Census of Agriculture files. Regional geological and geographic data were examined to identify topographic features within the six states. In combination, these data suggest that a majority of farms in these states are small acreage livestock operations, located on terrain with steep slopes, with annual value of sales <$10,000 a year, total equipment valued at <$20,000, with low prevalence of tractors with rollover protective structures (ROPS), and operators who work at off-farm jobs >200 days per year. Variations in these variables across the six states are examined as compared to the pooled values for all six states, and as compared to the pooled values for all U.S. farms. Surveillance methods for identifying, targeting, and implementing ROPS-promotion efforts within these states are described.