Childbirth is a universally celebrated event for thousands of women. The fundamental aim of the obstetrician is to deliver healthy children of healthy women. It is a recurring tragedy therefore that pregnancy and its complications still contribute on a worldwide scale, to death of women in the reproductive age group and perinatal deaths. Being an important issue, maternal mortality and perinatal mortality should be put into the consideration of different countries all over the world as they become nowadays part of the measurements and indicators of country development. The present work studied maternal and perinatal deaths in Kasr El Aini maternity hospital among 35939 pregnant women admitted from January 2010 to January 2012 , it was found maternal mortality rate in this hospital was 50.14 per 100,000 compared to 69.7 in 1975 ,60.4 in 1984, it is still much higher than in USA 34& 26 in Canada. Hemorrhage still constitutes the most common cause of mortality there. Perinatal mortality rate in this study was 46.38 far from that in advanced communities, intra-uteriene fetal death mostly an avoidable death still presents the most common cause of perinatal death. Fetal distress and prematurity were the main causes of immediate post partum deaths.