Reports of outcomes of pregnancy in women with type 1 diabetes have consistently found increased perinatal mortality and morbidity. The primary objective of our study was to compare the perinatal mortality rate in type 1 diabetic pregnancies with that of the general population. The secondary objective was to compare the morbidities in these groups. A series of 247 women with type 1 diabetes had 300 consecutive pregnancy outcomes analyzed over a 10-year period. They were compared with the control population from the same hospital. Perinatal mortality was 6.6/1000 (95% CI, 0-17), which was significantly lower than the control population rate of 31/1000. There was an increased incidence of morbidity including maternal hypertension, cesarean section, preterm delivery, birth injury, large for gestational age infants, admissions to neonatal intensive care, neonatal hypoglycemia, and phototherapy. Pregnancies in type 1 diabetes can be associated with a normal perinatal mortality rate although morbidity remains elevated compared with controls.