A simple prepartum and intrapartum scoring technic for the identification of high-risk patients was applied to 1,224 patients managed at the Charleston Area Medical Center, Memorial Division. The patients were classified as being at low, moderate, or high risk, according to the total risk score. Perinatal mortality worsened as the risk category increased. Seventy percent of all perinatal deaths occurred in 25% of patients who were identified as moderate- and high-risk patients. The simple one-page scoring form that we used seems to be practical and effective in identifying patients at risk. Such information can be very useful in providing appropriate levels of obstetric care.