Levin JB (Department of Applied Statistics, University of Reading, Whiteknights, PO Box 217, Reading RG6 2AN, UK), Macfarlane A and Bennett S. The comparison of trends in perinatal mortality in small areas. International Journal of Epidemiology 1990, 19: 78-89Year to year changes in perinatal mortality rates for small populations are difficult to interpret. Because local rates are based on small numbers of events, they are subject to apparently large fluctuations. A technique for analysing trends in mortality, for detecting changes in trends and comparing variations in trends between areas is described. It is illustrated by an analysis of perinatal mortality rates for Area Health Authorities in the West Midlands Region of England from 1974-1981, but the same techniques could be used to analyse trends at other times and in other places. © 1990 International Epidemiological Association.