Pregnancy outcomes of women 35 years of age or older are considered to be less favorable than those of younger women. To examine this hypothesis, the records of 26,795 deliveries of black women at Grady Memorial Hospital from 1973 to 1978 were analyzed. Infants of 788 women who were 35 or older had a perinatal mortality rate 1.7 times higher than did infants of younger women (47 versus 28 deaths per 1000 births; P less than .01). There was no difference, however, when women with preexisting hypertension were excluded from analysis. The incidence of primary cesarean section was significantly higher for women 46 or older (17% versus 10%; P less than .001), although incidences of infants with low birth weight, low Apgar scores, and maternal infections were not significantly different. Hypertension was a more important determinant of perinatal survival than was maternal age. Age alone did not appear to be an important obstetric risk factor for healthy women 35 years of age or older.