Background: Death of a foetus in-utero is devastating both to the parents and the attending obstetrician. Knowledge of the relative importance of the different causes will help in the prevention or reduction of its occurrence.Aim: This study evaluated the prevalence and pattern of stillbirths at the Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, South-East Nigeria.Methodology: This was a retrospective study of 297 stillbirths at the Nnamdi Azikiwe University Teaching Hospital, Nnewi from 1st January, 2007 to 31st December, 2011.Results: The stillbirth rate was 56.9/1000 deliveries. Majority of the cases 238 (80.1%) were unbooked. One hundred and twenty-nine (43.4%) were nulliparous. There were 180 (60.6%) male stillbirths while 117 (39.4%) were females. The major causes were abruptio placentae 40 (13.5%), prolonged pregnancy 38 (12.8%), uterine rupture 37 (12.5%) and pre-eclampsia 31 (10.4%). Seventy (23.6%) cases were unexplained.Conclusion: The stillbirth rate is high in our centre. There is need for quality, accessible and affordable antenatal care and delivery services to reduce the rate of stillbirth. Establishment of a subspecialty of prenatal diagnosis and foetal medicine will help in reducing the rate of stillbirths in our environment.Keywords: Foetal death, nulliparous, obstetric care, risk factors, unbooke