Perinatal mortality rate is an important indicator of community health status. This study is to analyze the cause of perinatal death in Teaching Hospital, Batticaloa. A retrospective study was done over a period of last three and half years from January 2014 to June 2017, which included total 21,079 deliveries out of which 204 perinatal deaths occurred, hence perinatal mortality rate was 12.51 per 1000 birth on 2014, 15.11 per 1000 birth on 2015 and 13.28 per 1000 birth on 2016. The causes of perinatal deaths and risk factors were identified and analyzed. Out of 204 perinatal deaths, majority (53.4%) occurred due to pretermwith or without associated other factors, majority (87.2%) of perinatal death occurred in maternal age of 20-39 years, and found to be more common in (64.8%) multigravida patients and majority of perinatal deaths (58.3%) occurred during early neonatal period. Early identification of mothers at risk of pregnancy complications, especially intrauterine growth restricted fetuses, through antenatal care screening, educating pregnant women to recognize warning signs of pregnancy complications, timely access to obstetric care, monitoring of labour for fetal distress, and proper newborn resuscitation may reduce some of the categories of deaths. Fetal autopsy in future could detect many unknown causes. There should also be increased communication to work closelybetween neonatology team and obstetric team to bring down perinatal mortality