Vital statistics data have been used to track maternal and child health in the United States since the early 1900s. The breadth of information collected on birth and death certificates coupled with advances in computer processing have made possible critical perinatal and obstetric research. These enhancements also facilitate potentially problematic uses of the same data. This commentary explores characteristics of the United States Vital Statistics System and presents some thoughts with regard to the appropriate use of these data. The advantages of vital statistics include representativeness and the ability to examine subpopulations. Limitations include possible underreporting of medical conditions and procedures, lack of ability to ascertain clinical intent, and the well-known issues with gestational age reporting. Analyses based on vital statistics are important in informing future clinical research projects. However, respecting the limitations of vital statistics data enhance their appropriate role in obstetric and perinatal research.