A large population-based study of all stillbirths and neonatal deaths occuring on the island of Jamaica during a 12 month period is described. During this time, 2069 perinatal deaths were identified from an estimated population of 54,400 total births giving a perinatal death rate of 38.0 per 1000 total births. The death rate was 5 times higher among twins than singletons. An attempt was made to obtain detailed postmortem examination of as many deaths as possible. In the event, 51 por ciento of perinatal deaths received such a postmortem examination, for the most part by 3 specially trained pathologists working in the capital. Postmortem rate was affected by sex, multiplicity of the infant, month of death and area of delivery. Deaths were classified using Wigglesworth scheme. The distribution categories was similar in the months when the postmortem rate was 70 por ciento to the rest of the time period when the post-mortem rate was only 40 por ciento . The Wigglesworth classification of deaths identified those associated with intrapartum asphyxia as the most important group, accounting for over 40 por ciento of deaths. This simple classification is important as it focusses attention on details of labour and delivery that may require change and is useful in planning future delivery of obstetric and neonatal care.