Perinatal mortality remains a global and national public health problem, contributing substantially to infant mortality in Indonesia. Various risk factors, including maternal nutritional status, access to health services, and socioeconomic conditions, may contribute; however, comprehensive empirical evidence based on national data remains limited. This study employed a cross-sectional design using secondary data from the 2023 Indonesian Health Survey (SKI), covering Indonesia. The sample comprised 70,526 mothers who gave birth and met the study criteria, identified from the 2023 SKI database. Analyses were performed using the Chi-Square test and logistic regression. This study obtained ethical approval from the Health Research Ethics Committee under ethics approval code FRM/SMKI-PUSDATIN/70. The results showed 397 cases of perinatal death (0.56%) among total births. Multivariate analysis indicated that twin infants had a fivefold higher risk of perinatal death (OR=5; 95% CI: 3.24–8.58; p=0.000). Antenatal examinations conducted by non-health personnel doubled the risk (OR=2; 95% CI: 1.57–3.14; p=0.000). Poor household economic status was significantly associated with increased risk (OR=1; 95% CI: 1.05–1.72; p=0.018). Conversely, inaccessible family support demonstrated a protective effect (OR=0.74; 95% CI: 0.56–0.98; p=0.042). Iron supplementation, healthcare access, maternal occupation, maternal education, and anemia were not significantly associated with perinatal mortality. In conclusion, factors influencing perinatal mortality in Indonesia include twin pregnancy, antenatal care by non-health personnel, and low economic status, while family support is protective. Risk is higher among twin infants and rural areas, requiring strengthened antenatal services, high-risk pregnancy monitoring, and interventions addressing social support and regional conditions.