PIP: The survey purpose was to review as far as possible all of the perinatal deaths occurring in Harare, Zimbabwe. The maternity services within Harare consist of 3 maternity hospitals together with municipality-operated urban maternity clinics in the residential suburbs. All births taking place within the maternity services during 1983 were analyzed. An estimate of the number of patients giving birth within the city but outside these services was made after consultation with the City Medical Officer. All cases of perinatal deaths were analyzed to assess the cause of death, the registration status of the mother, and the birth weight of the baby. An estimate of perinatal deaths occurring outside the maternity services also was made from the City Medical Officer's annual report, newspaper reports of baby dumping, and after consultation with the City Social Services and the police. There were an estimated 53,665 total births and 2103 perinatal deaths in Harare during 1983. 94% of the births were delivered within the hospitals or clinics; 1.8% were born before arrival (BBA) to the maternity service. 4.8% were not born within the city maternity services. 1714 (18.5%) perinatal deaths occurred from babies born in the hospitals or clinics, and 134 (6.4%) from babies born before arrival at maternity services. An estimated 255 (12.1%) of deaths occurred elsewhere. Those infants born before arrival made up 1.8% of the total births and accounted for 6.4% of the total perinatal deaths. Of the 53,665 births within the City of Harare during 1983, 47,285 (88%) were booked for antenatal care at either a municipal clinic or hospital. 6380 (12%) patients did not register for antenatal care, and 909 (43.2%) perinatal deaths occurred in the unregistered groups of patients. The overall perinatal mortality rate (PNMR) was 39.2/1000. For registered patients the PNMR was 25.3/1000; it was 142.5/1000 for unregistered patients. 1685 (80.1%) perinatal deaths were in infants weighing 1000 g or more; 418 (19.9%) perinatal deaths occurred from infants weighing less than 1000 g. Unexplained stillbirth, immaturity, intrapartum asphyxia, and antepartum hemorrhage were the principal cause of death accounting for almost 60% of the total perinatal mortality.