Among 139,948 perinatal deaths (53,001 MSB, 51,566 FSB and 35,381 END), the annual average perinatal death rate was 23/1,000 births, reducing by an average of 8 % per year from 28/1,000 in 2017 to 19/1,000 in 2021 (OR=0.92, CI=0.91-0.92). Stillbirths declined by an annual average of 6% (OR=0.94, CI=0.94-0.95). Early newborn deaths declined at an annual average of 9% (OR=0.91, CI=0.90-0.9). Districts with regional referral hospitals such as Masaka, Hoima, Mubende, Jinja and Kampala reported the highest perinatal death rates.