OBJECTIVE To determine the incidence rate and causes of perinatal mortality and make a comparison between the incidence rate and causes of perinatal mortality in the prewar (1986-1991), war (1992-1995) and postwar (1996-2005) periods in Tuzla Canton, Bosnia and Herzegovina. METHODS We retrospectively collected data from the databases of University Department for Gynecology and Obstetrics Tuzla. Data on the number of live births, stillbirths, early neonatal deaths, causes of death, gestational age and birth weights were collected. RESULTS There were 101712 deliveries all together in the above mentioned period, out of which 101638 resulted in liveborn children. Perinatal mortality gradually declines in the period of 1986-2000. The decline owns mostly to early neonatal mortality more than to fetal which also shows the trend of decrease. Statistically significant difference in perinatal mortality was found between period 2001-2005 and another analysed periods, and the most difference was found between 1991-1995 and 1996-2000 (p < 0.01). Statistically significant difference in fetal mortality was found between period 2001-2005 and 1986-1990. Statistically significant difference in early neonatal mortality was found between period 2001-2005 and 1986-1990 (p = 0.005; p < 0.005). CONCLUSIONS Perinatal mortality in Tuzla Canton were significant higher during the war, mainly due to lower adequacy and accessibility of perinatal health care. During the peace period a significant decline of perinatal mortality is registered, due to early neonatal death.