Objectives:  To determine the perinatal mortality rate at Prince Rashed Hospital and the main causes of perinatal deaths and their risk factors. Methods: We reviewed the data of all deliveries that took place at Prince Rashed Hospital from January 2005 to January 2006 including number of live births, stillbirths, maternal age, parity, mode of delivery, antenatal care, obstetric history, and the infant details like gestational age, gender and outcome.   Results: During the study period, there were a total of 6225 deliveries. The perinatal mortality rate was 18.2/1000 births, There were 63 stillbirths and 50 early neonatal deaths. The male to female ratio was 1:1(3105 to 3 120. 68% of babies born were considered low birth weight (<2500 g) and this was associated with a high perinatal mortality rate (206.4/1000).   Conclusions The perinatal mortality rate is still high in our hospital as compared to Europe but lower than that in Far East and African countries. Low birth Weight is still an important risk factor.