In 2015, of the nearly 362,600 babies born in Rwanda, 5,900 were stillborn and 6,300 died in their first month of life. In the same period, 1,100 women died during pregnancy or from childbirth-related causes.With all eyes focused on achieving the Sustainable Development Goals (SDGs), Rwanda is looking to accelerate efforts to improve outcomes for women and babies. There is global consensus that accurate information about causes of death through mortality audits is needed to help inform efforts to end preventable maternal and perinatal deaths. The Rwandan Ministry of Health (MOH) and the United States Agency for International Development’s Maternal and Child Survival Program (MCSP) aimed to document experiences in implementing maternal death review, perinatal death review, and/or integrated maternal and perinatal death surveillance and response (MPDSR) processes in Rwanda. Rwanda was one of four countries selected as part of a multicountry assessment of MPDSR processes at the district level. The assessment sought to identify factors that have affected the uptake and sustainability of implementing MPDSR systems to improve the quality of care and to prevent future deaths.