Urbanization can be a challenge and an opportunity for earthquake risk mitigation. However, little is known about the changes in exposure (for example, population and urban land) to earthquakes in the context of global urbanization, and their impacts on fatalities in earthquake-prone areas. We present a global analysis of the changes in population size and urban land area in earthquake-prone areas from 1990 to 2015, and their impacts on earthquake-related fatalities. We found that more than two

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... thirds of population growth (or 70% of total population in 2015) and nearly three quarters of earthquake-related deaths (or 307,918 deaths) in global earthquake-prone areas occurred in developing countries with an urbanization ratio (percentage of urban population to total population) between 20 and 60%. Holding other factors constant, population size was significantly and positively associated with earthquake fatalities, while the area of urban land was negatively related. The results suggest that fatalities increase for areas where the urbanization ratio is low, but after a ratio between 40 and 50% occurs, earthquake fatalities decline. This finding suggests that the resistance of building and infrastructure is greater in countries with higher urbanization ratios and highlights the need for further investigation. Our quantitative analysis is extended into the future using Shared Socioeconomic Pathways to reveal that by 2050, more than 50% of the population increase in global earthquake-prone areas will take place in a few developing countries (Pakistan, India, Afghanistan, and Bangladesh) that are particularly vulnerable to earthquakes. To reduce earthquake-induced fatalities, enhanced resilience of buildings and urban infrastructure generally in these few countries should be a priority.