Introduction: perinatal mortality is one of the most important indicators of the reproductive health of the population, therefore, its analysis and development of measures to reduce it are priority areas in the process of stabilizing the demographic situation. Purpose: analysis of perinatal mortality rates in the Republic of Mordovia, establishing the causes and developing a strategy for solving the problem. Materials and methods: analytical, statistical, Pearson's method. Results and discussion: a brief description of the obstetric care service of the Republic of Mordovia is given by the levels of medical care. It was revealed that in Mordovia the level of perinatal mortality is lower than in the country as a whole, however, there is heterogeneity in the distribution of the indicator among the regions of the republic. The analysis of the structure of perinatal mortality was carried out, a correlation was found between perinatal mortality and early medical examination of pregnant women, as well as the number of births complicated by anemia. Conclusions: a positive assessment has been given to the work of the obstetric care system in Mordovia, a strategy has been outlined for the activity of the health system on the path to reducing perinatal mortality.