Background - With more than 9,000 births in 2016, Mayotte is home to the largest maternity ward in France. However, few up-to-date and comprehensive data on perinatal health are available for this department. Objective - This study was conducted to provide an updated overview of perinatal health, assess its evolution compared to 2010, and compare it with the situation in mainland France. Materials and Methods - This study included all women who gave birth in Mayotte between March 14 and April 17, 2016; data collection, carried out by teams of interviewers (midwives and translators), consisted of a face-to-face interview, data collection from medical records, and a self-administered questionnaire in French. A wide range of topics were covered: sociodemographic characteristics, health before and during pregnancy, contraception, prenatal care, the course of labor and delivery, and the newborn’s health at birth. This article presents the main results and compares them with those obtained in the department during the last National Perinatal Survey (ENP) in 2010 and with the metropolitan results of the 2016 ENP. Results - Women giving birth in Mayotte were young; their precarious living conditions had worsened since 2010, and 61.9% of them lacked health insurance coverage. Prenatal care fell short of HAS recommendations for 70.3% of mothers. Midwives attended 83.1% of deliveries; obstetric interventions and complications were less frequent than in mainland France. The preterm birth rate (11.8% in 2016), stable since 2010, remained higher than the mainland rate. Some questions had high non-response rates, partly attributable to the low level of education and insufficient medical care among mothers. The likely presence of underdiagnosis bias (linked to gaps in medical care for certain mothers) constitutes another limitation of the study. Conclusions - The findings of this study shed light on the perinatal situation in Mayotte, which is necessary for defining a health policy adapted to the socio-health context.