ABSTRACT. We examined the distribution and demographic characteristics of congenital anomalies in a Turkish province for five years. The records of 63,159 live births between 2000 and 2004 were examined retrospectively. Major congenital anomalies were classified according to year, organ system, gender, family relationship, maternal age, mortality rate, and method of delivery. There were 183 cases of major birth defects among 63,159 live births, giving a prevalence of 2.9/1000. Anomalies of the central nervous system were the most common defect (31%), followed by cleft palate/lip (19%), musculoskeletal system anomalies (14%), and chromosomal anomalies (13%). Among the infants with major anomalies, 14% did not survive, 56% were delivered vaginally, and 25% were miscarried. There was a significant increase in rate of major congenital anomalies during the five-year period.