Placental abruption (PA), despite recent improvements in prenatal diagnostic methods, continues to be one of the major causes of maternal morbidity and neonatal mortality. This retrospective cohort study design was used to assess predictors of perinatal mortality in women with placenta previa and abruption between January 2012 and December 2018. Eight hundred sixty-four women (506 with placenta previa and 358 with placental abruption) were eligible for analysis. Binary logistic regression, Kaplan-Meier survival curve, and receiver operating characteristic (ROC) curve were used. On admission, 74% of the women were anaemic (<10 gm/dL) with mean haemoglobin level of 8.0 ± 3.0 gm/dL. The proportion of overall severe anaemia increased from about 35% on admission to 43% at discharge. There were 50% perinatal deaths (neonatal deaths of less than seven days of age and fetal deaths after 28 weeks of gestation). In the adjusted odds ratios, lengthy delay in Zeliten Medical central hospital care, prematurity, anaemia in the mothers, and male foetuses were independent predictors of perinatal mortality. The haemoglobin level at admission was more sensitive and more specific than prematurity in the prediction of perinatal mortality. The proportion of severe anaemia and perinatal mortality was probably one of the highest in the world.