Purpose – to analyze the rate of early neonatal mortality (RNM) in the regional institution of the third level – the Krasnoyarsk regional clinical center of maternity and childhood. Materials and methods. A retrospective comparative analysis of the RNM index for three years (2015-2017) was carried out focused on the gestation period, newborn body weight, and the presence of obstetric complications. Results. Considering the RNM by gestation age, it was found that the vast majority of births were premature – 93.3 % out of the total number. At the same time, in 47 % of cases, preterm labors occurred in the most unfavorable terms of perinatal loss gestation period – in 22-28 weeks (47 %) and in 29-33 weeks of gestation (13.8 %). In most cases, the RNM is marked by a high rate of delivery by cesarean section (in 64 % of cases), while in the vast majority of cases – indications for these operations were targeted for the benefit of the fetus, in particular decompensated placenta insufficiency (in 73.9 % of cases). The cause of death of newborns in pregnant women with decompensated placenta insufficiency was the implementation of purulent-septic complications, such as early neonatal sepsis and intrauterine pneumonia. Conclusion. The growth rate of RNM in the Institution of the third level in 2017 occurred due to the high incidence of delivery in pregnant women during critical gestational periods (very early and early preterm birth) with heavy decompensated placenta insufficiency. The method of delivery in pregnant women with decompensated placenta insufficiency at gestational age up to 28 weeks of pregnancy does not significantly affect the RNM index.