Background
Perinatal mortality is one of the serious challenges in meeting maternal and child Millennium Development Goals in developing countries. Identifying its predictors is an important step to develop focused and appropriate health interventions for reducing perinatal deaths. This study therefore aims at identifying predictors of perinatal mortality in a rural setting in northwest Ethiopia.

Methods
A prospective longitudinal study was conducted at Dabat Health and Demographic Surveillance site, northwest Ethiopia, from November 2009 to August 2011. Data were collected by interviewing the mothers or guardians of eligible children. Multiple logistic regressions were employed to identify potential predictors.

Results
A total of 1752 eligible children were included in the study. Perinatal mortality rate in the study population was 50.22 per 1000 (95% CI: 39.99, 60.46) total births. In multiple logistic analysis, previous still birth [(AOR?=?8.38, 95% CI: 3.94, 17.83)], twin birth [(AOR?=?7.09, 95% CI: (3.22, 15.61)], not receiving tetanus toxoid vaccine during the index pregnancy [(AOR?=?3.62, 95% CI: 1.57, 8.34)], short birth interval of less than 24 months [(AOR?=?2.58, 95% CI: (1.61, 4.13)], maternal illiteracy [(AOR?=?4.83, 95% CI: (1.45, 16.05)] and mothers’ running own business [(AOR?=?5.40, 95% CI: 1.40, 27.96)] were the main predictors associated with increased risk of perinatal death.

Conclusions
Predictors of perinatal death in the study area are easily recognizable and potentially preventable with the existing maternal health programs. Efforts need to be intensified in expanding maternal and newborn health services to significantly reduce perinatal mortality in rural settings.