Perinatal mortality rate is a sensitive indicator of quality of care provided to women in pregnancy, at and after child birth and to the newborns in the first week of life. Regular perinatal audit would help in identifying all the factors that play a role in causing perinatal deaths and thus help in appropriate interventions to reduce avoidable perinatal deaths. A retrospective study of perinatal indices was conducted among 816 births delivered during the period of 1 year from April 2007 to March 2008 in Nepal Medical College. There were 11 still births and 11 early neonatal deaths. Breech presentation with stucked head and respiratory distress syndrome in preterm babies are the common causes for perinatal mortality. Within the Wigglesworth's classification; group 1, 3 and 4 are the common groups of perinatal death. The 76.5% of perinatal deaths and 100% of early neonatal deaths were low birth weight babies. Similarly 72.5% of perinatal death and 82% of early neonatal death were preterm babies. The perinatal mortality was 26.9/1000 births, comparable to other studies, but still emphasis should be given to upgrade the neonatal care. The efforts should be made for regular antenatal checkups and improvement of neonatal care.