In developing countries perinatal mortality rate (PMR ) has continues to represent a huge burden it is five times higher in developing than developed countries. Each year at least 3.3 million babies are stillborn, more than 4 million die within 28 days of birth, and a further 6.6 million young children die before their fifth birthday. The highest PMR are reported from sub - Saharan Africa (about 80 per 1000 births ), followed by Asia and Latin America (UNICEF 2008). In sub - Saharan Africa alone 1.2 million babies die in the first month of life and another million babies are stillborn each year. In Western Europe, neonatal and infant mortality has declined during the last 30 years to 4-6 per 1000 births . The improvement is Primarily due to improved socio -economic and living conditions , nutrition of pregnant women and advancements in obstetric and neonatal care. This book Describes measures that can be instituted to help decrease the burden of perinatal mortality through use of medical audit.