Background: Perinatal mortality is an important indicator of maternal care, health and nutrition, it also reflect the quality of obstetric and the pediatric care available. The majority of global perinatal death occurs in the low and middle socioeconomic countries. Our hospital being a tertiary level facility receiving complicated cases from urban as well as remotes areas so this study was carried out here. The present study was conducted to study obstetric factors leading to perinatal mortality at a tertiary centre. Materials and Methods: The present prospective observational study was undertaken in a tertiary centre from October 2016 to March 2018. All perinatal deaths including stillbirths (SBs) and early neonatal deaths within 0-7 days of birth after 28 weeks of gestation were analyzed. Results: Out total 163, 10 cases had congenital malformation. 153 cases i.e. 93.86% had no obvious congenital abnormality. Out of 10 congenital anomalies 2 cases had congenital heart disease. 2 cases had anencephaly. 1 case congenital Diaphragmatic hernia, 3 cases had cleft lip, cleft palate, 2 cases had hydrocephalous. Conclusion: Majority of perinatal deaths are preventable by regular ANC check up and early detection of high obstetric factors before pregnancy and during gestation.