Objective: The purpose of this study was to describe neonatal mortality rates among live births that were complicated by placenta previa in the United States. Study Design: This was a population-based retrospective cohort study of 1997 United States singleton live births. Neonatal deaths among pregnancies that were complicated by placenta previa were compared with deaths among pregnancies with no placenta previa. Adjusted and unadjusted hazard ratios were generated from a proportional hazards regression model. Results: Of 3,773,369 live births, 9656 were complicated by placenta previa (2.6 cases per 1000). Among cases of placenta previa, 114 neonatal deaths occurred (11.8 per 1000) versus 14951 (4 per 1000) among non-placenta previa neonates (P < .0001). The adjusted relative risk of death was three times higher among placenta previa neonates (hazard ratio, 3.06; 95% CI, 2.40-3.94). Placenta previa-related death was mediated through preterm delivery rather than small for gestational age. Conclusion: Placenta previa triples the rate of neonatal mortality, which is mediated mainly through preterm birth. (Am J Obstet Gynecol 2003;188:1305-9.)