The study of the perinatal mortality was carried out in the Omskaya Oblast from 1996 to 2005. The ample decrease of the perinatal mortality from 14.64 per 1000 newborns in 1996 to 10.21 in 2005 is noted. At the same time, the decrease of the still-born rate was less marked in comparison with the earlier neonatal mortality. The assessment of the analyzed indicators in the urban and rural settlements testify to the usefulness of the activities applied by the urban medical care institutions in comparison with the rural ones. The analysis of the fetus loss rates before and during the delivery and the comparison of the levels of the newborns mortality during the first week of their life in the formation of the urban and rural perinatal mortality in the aggregative (i.e. Five-year) periods give grounds to consider that that further decrease of the perinatal mortality will be restrained by the antenatal losses. In the present-day decade a tendency in increasing the numbers of small-for-date fetuses both in the urban and rural areas is taken shape. More pronounced deterioration of the physical development of new generations to come is noticed among rural population. The full accounting of the factual losses of fetuses and children is needed to make optimal management decisions promoting the development of the perinatal service and the decrease of the morbidity and mortality of children.