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The findings at autopsy in 99 cases of perinatal deaths in a ten-year period and on pathologic examination of the accompanying placentas in 39 cases were analyzed clinicopathologically. Also reviewed were the pathologic diagnoses of 225 placentas that were examined for causes other than neonatal death. Cardiovascular and pulmonary problems, particularly hyaline membrane disease, atelectasis and cardiac anomalies were most common. Asphyxia, heart failure and premature placental separation were the most frequent causes of death. In slightly more than half of the cases a reasonable final diagnosis was established by autopsy, and if the placenta was examined, nearly two-thirds could be properly classified. In the remaining 37 per cent, as previously reported in larger series, neither the autopsy nor placental examinations disclosed a satisfactory explanation of the perinatal death.