Background: Breech deliveries have always been topical issues in obstetrics because of the very high perinatal mortality and morbidity. These are due to combination of trauma, birth asphyxia, cord compression and prematurity malformation. Irrespective of mode of delivery, neonates undergoing term breech deliveries have long-term morbidity up to the school age. Thus, a wide range of management policies have been instituted with the aim of reducing this perinatal morbidity and mortality, and hence improve the quality of life of the infant .However, limited evidence is available on factor affecting perinatal outcome of singleton breech delivery. Objective: To determine the perinatal outcome and associated factors of single tone term breech deliveries at Yirgalem General Hospital from August 2013 to July 2017. Methods: Hospital based cross-sectional study was conducted on 374 participants retrospectively. Socio-demographic and pregnancy related information of all pregnant women who presented with a breech presentation and delivered in the hospital were reviewed from Patient medical records using structured check list by trained data collectors from march 20 to April 30/2018. The collected data was checked for its Completeness, entered, edited, cleaned and analyzed using SPSS for windows version 20. The data was described and presented using narrative text, tables and graphs. Result: A total of 374 singleton term breech deliveries were included. The prevalence of singleton term breech deliveries in the hospital was 3.3%. The perinatal outcome of breech deliveries 51(13.6%) were dead. The possible cause of death were 18(35.3%) enterapment of after coming head, 13(25.5%) birth asphyxia ,10(19.6%) cord prolapsed and 10(19.6%) were unknown cause. Vaginal delivery (AOR=2.84(1.13-7.16)), ruptured membrane (AOR=1.66(0.78-3.55)), fully cervix (AOR=1.88(0.87-4.06)), presence of cord (AOR=4.34(1.75-10.72), primigravida (AOR=3.72(1.35-10.54) and skill of the attendant remained the strong independent risk factors. Conclusion: The perinatal mortality rate was high. Factors such as primigravida, ruptured membrane, fully dilated cervix, skill of attendance and vaginal route of deliveries are significantly associated with increased perinatal mortality in singleton breech delivery.