Aims: There paucity of studies on asphyxia, one of the three main reasons for newborn deaths in Democratic Republic of Congo (DRC). In this country, newborn mortality is among the highest in Africa. This study was conducted to identify the clinical features and outcome of perinatal asphyxia. Risk factors associated with asphyxia were also determined. Study Design: A cross-sectional study. Place and Duration of Study: It was conducted in the pediatric department of Hôpital du Cinquantenaire of Kisangani (HCK), from March 2013 to March 2017. Methodology: Clinical and biologic parameters (prenatal, perinatal and postnatal) of term newborns, hospitalised for perinatal asphyxia in the HCK were retrospectively collected and analysed. Data of dead newborns were compared to those who survived to determine risk factors associated with asphyxia mortality. One case matched three controls of the same sex. Results: During the period above, 612 newborns were received in the HCK, and 146 died. One hundred and nineteen out of 612 had perinatal asphyxia (19.4%), and 26 out of 119 died (17.8% of all newborn deaths and 21.8% of all asphyxia cases). The most frequent perinatal antecedents were premature rupture of the membranes, meconium-stained amniotic liquid, pre-eclampsia and eclampsia. In bivariate analysis, factors associated with asphyxia lethality were low birthweight (P=.02), reference from another hospital (P =.01), age more than 24 hours (P =.02), associated sepsis (P =.003), asphyxia severity (P<.001) and the Stage 3 of Sarnat (P<.001). Conclusion: The frequency of the asphyxia is high in the HCK and its mortality associated with avoidable factors. Networking newborn referral, improving skills of nurses about obstetrical and neonatal emergency cares, and making available equipment for newborn resuscitation can reduce that mortality.