In the Peristat-project, a European collaborative study, a set of indicators has been defined for monitoring perinatal health outcomes. For a group of 10 core indicators, with variables for subgroup analysis, national registry data from 15 European member states were collected and compared. The Netherlands was found to have the highest perinatal mortality in Europe: the foetal and neonatal mortality amounted to 7.4 and 3.5 per 1000 births, respectively. European countries differ in registration practices. Some countries do not register perinatal deaths occurring before a duration of amenorrhoea of 28 weeks. Therefore, the Peristat mortality data should be compared with 28 weeks of gestation as a cut-off point. With this cut-off point, The Netherlands has the second highest perinatal mortality. A number of factors may have contributed to this relatively high mortality, such as differences in registration practices, the profile of the Dutch childbearing population and the characteristics of Dutch perinatal care. The Netherlands has a relatively high proportion of older mothers, multiple births and mothers belonging to an ethnic minority. Also, Dutch neonatologists are known to be conservative in their treatment of premature newborns, which reduces their chances of survival. There is also less prenatal screening for congenital abnormalities in The Netherlands than in many other European countries. Further analysis of the Dutch data, as well as continued monitoring at the European level, can serve as a basis for future policy decisions to enhance the health of Dutch mothers and newborns.