Epidemiological data derived from death certification in the absence of a necropsy can be erroneous. Despite concern over adult hospital necropsy rates, which have fallen dramatically in the last 40 years, relatively less has been published regarding perinatal necropsy rates. A literature review of necropsy rates for neonatal deaths, stillbirths and perinatal losses was undertaken. There is a wide variation in the perinatal necropsy rates worldwide but the numbers appear to be higher than adult hospital rates. The necropsy rate for neonatal deaths appears to be lower than that for stillbirths. It is hoped that the review will serve to alert readers to remain vigilant against any fall in the perinatal necropsy rates.