In recent years, there have been increased efforts to reduce the high maternal mortality ratio (MMR) in Papua New Guinea. This retrospective study conducted at Modilon Hospital in Papua New Guinea documented maternal and perinatal mortality over the 6 years from 2009 to 2014. In-hospital maternal mortality, though still high, significantly declined by over 50% from 24/2598 (924 per 100,000) in 2009 to 12/3217 (373 per 100,000) in 2014 (p <0.001) while stillbirth rates and early neonatal death rates remained unchanged. There is a need for an approach with interventions aimed at reducing both maternal and perinatal mortality. While monitoring and auditing of maternal deaths should be possible throughout the entire country, in settings where there is limited capacity to monitor population-based perinatal and neonatal mortality, an emphasis on improved data quality as part of hospital-and health centre-based surveillance can provide important information.