The incidence of pre-existing diabetes in women of reproductive age is rising worldwide. This is particularly alarming, as the complications of a diabetic pregnancy are well recognised and may result in stillbirth or neonatal death. This audit aims to review the maternal and diabetic characteristics of diabetic stillbirths at a major tertiary centre in order to determine the cause of death and possibly reduce the incidence of future stillbirths. All stillbirths of diabetic mothers at Westmead Hospital during 2006-2017 were retrospectively identified through an obstetric database. Paper medical records and the local clinical database were then utilised to obtain data pertaining to maternal, obstetric and diabetic characteristics, antenatal screening and autopsy results. Stillbirths were categorised into common causes. Of the 22 women included in the audit, 5 had Type 1 diabetes (T1DM), 8 had Type 2 diabetes (T2DM) and 9 had gestational diabetes (GDM), with a total of 23 stillbirths. Major congenital malformations were identified as the most common cause of stillbirth in 5 cases, followed by obstetric factors and intra-uterine growth restriction (IUGR) in 4 subjects each. Malformations were predominantly cardiovascular (n=3) , central nervous (n=3) and musculoskeletal (n=3), consistent with known diabetic anomalies. Amongst the stillbirths, there was no difference in malformations between the T1DM or T2DM groups (p=0.16). Suboptimal glycaemic control defined as HbA1c >6% was present in all 5 T1DM subjects, 6 out of 8 T2DM subjects and 1 out of 7 GDM subjects at some stage during the pregnancy. In the crucial first trimester, 3 out of 3 T1DM subjects and 3 out of 5 T2DM subjects had inadequate glycaemic control. Our study has illustrated the need for more aggressive management of diabetic pregnancies, particularly of pre-existing diabetes prior to pregnancy, in order to reduce the risk of stillbirth.