The Perinatal mortality rate is an important index of community health condition and quality of health service provided to the mother and their fetus during the 28 weeks of gestation till, after delivery, there are many factors that threaten their life. This study aimed to determine the perinatal mortality rate in Baghdad AL Karkh health directorate and to identify the contributing factors and main causes of perinatal mortality.A study based on a record review of the perinatal mortality in three hospitals in Baghdad Al-karkh for a one year starting from 1^st April 2018 and at the end in March 2019.The total deliveries were 27,096, while the total deaths were 1217 deaths during the perinatal period the perinatal mortality rate was 45 /1000, 67% of them with newborn death, 57% of fetal gender was male, 64 % of perinatal deaths were delivered by cesarean section, the most common maternal contributing factors is the complication of labor and delivery was 24% while the fetal causes are Respiratory and cardiovascular disorders specific to the perinatal period was 56%, the study revealed a significant relation or association between gestational age, mode of delivery, place of delivery, a product of delivery and age of the baby when dead and in another side this study revealed a no association between the mother's age, gender of the baby and the Weight of the baby . The main causes of perinatal mortality deaths occur during the first 2 days and may be modifiable with simple targeted perinatal policies with, quality improvement of the health care providing in labor rooms and neonatal care units.