Background: Perinatal mortality includes both stillbirths and early neonatal deaths. Perinatal mortality rate serves as a sensitive index of maternal and neonatal care. The increased risk of death is seen in low socio economic status, high and low maternal age, high parity, severe anemia, preeclampsia and low birth weight. Objectives: To study the determinants of perinatal mortality. Methodology: A case control study was conducted from January 2011 to August 2011 at__ampersandsignnbsp; ijayanagar Institute of Medical Sciences, Bellary. The study included 150 cases and 150 controls. Data was analysed using epi-info software version 3.4.3. Tests like proportions, Univariate and multivariate logistic regression was done. Results: The study revealed that anemic mothers (OR 1.3-5.0 at 95%CI), mothers with preeclampsia (OR 1.0-5.1 at 95%CI), mothers who had consanguineous marriages (OR 4.1-16.6 at 95%CI) and low birth weight of the baby (OR 3.1-13.3 at 95%CI) emerged as independent risk factors for perinatal death. Conclusion and Recommendations: Factors potentially amenable to intervention would be improving the maternal nutritional status and adolescent health by proper implementation of existing health programs and reducing the maternal morbidity by providing proper antenatal care and proper referral services.