【Objective】 To investigate the relationship between perinatal risk factors and early neonatal death among very low birth weight (VLBW) infants. 【Methods】 A retrospective cohort of 143 VLBW infants admitted to NICU was studied.The dependent variable was the outcome,either survival or death at 7 days of life.The independent variables were assigned into three levels:distal,intermediate and proximal according to hierarchical model.All variables were subjected to univariate analysis and multivariate logistic regression. 【Results】 Early neonatal mortality was 13.29% (19/143) in VLBW infants.After the adjustment of variables through multivariate Logistic regression it showed that infants born to mother with cord prolapse had higher risk exposure for early death than those of mother without cord prolapse in the distal level (AOR:8.69;95%CI:1.128~67.002).At the intermediate level,infants with gestational age (GA)<28 weeks and 5-min Apgar scores<7 had higher odds of early death than those of GA≥28 weeks and 5-min Apgar scores≥7 (AOR:11.47,13.55;95%CI:2.066~63.712,3.156~58.221 respectively).At the proximal level,infants with intracranial hemorrhage (ICH) had higher risk of early death than those without ICH (AOR:4.56,95%CI:1.088~19.170). 【Conclusions】 The early neonatal mortality among VLBW infants is still high and continues to be a significant public health problem.Asphyxia at birth is the highest risk factor of early neonatal death.Reducing birth asphyxia through enhancing obstetric quality and strengthening cooperation between obstetric and neonatology department is still the key to decrease early neonatal death of VLBW infants.