Hypothesis/aims of study. The perinatal mortality rate is a comprehensive indicator of social well-being, economic development and the state of medical care in any country. The aim of this study was to analyze perinatal loss dynamics in St. Petersburg and the Leningrad Region for 2006-2018 so as to determine the reserves for the reduction of perinatal mortality. Study design, materials and methods. Regional statistical reports on perinatal mortality in St. Petersburg and the Leningrad Region for 2006-2018 were analyzed. Results. A retrospective analysis of perinatal loss dynamics in St. Petersburg and the Leningrad Region was carried out. The structure of perinatal losses by birth weight of the fetus/newborn was surveyed. The proportion of children who died perinatally in the total number of deaths before reaching the age of 18 was determined. The main reserves for reducing perinatal mortality have been identified. Conclusion. With a clear tendency for perinatal mortality in St. Petersburg and the Leningrad Region to decrease during the study period, the absolute number of stillbirths does not show such a tendency.