Background: Until February 2022, Peru had overcome 3 waves and was placed as the country with the highest COVID-19 accumulated mortality rate worldwide. Across the 3 waves, a difference in cases and deaths have been reported. Aims and objectives: Assess the COVID-19 mortality rate and case incidence in Peru from March 6th, 2020, to February 28th, 2022. Methods: Ecological observational study evaluating open data at a district level during the pandemic and in 3 arbitrarily defined waves. 1874 Peruvian districts, with 3 372 962 COVD-19 cases and 212 017 deaths were included. The total mortality rate and case incidence as well as divided by age and gender were calculated. Results: The pandemic had a total case incidence of 11.48 cases per 100 population; the first wave, 3.04; the second one, 3.58; and the third one, 4.06. The overall mortality rate in Peru was 7.22 deaths per 1000 population; in the first wave, 2.98; in the second one, 3.49; and in the third one, 0.26. Case incidence between the female and male population was similar, but the male mortality rate was in every period around 1.8 times higher, except for the third wave with 1.38. The highest case incidence was seen in the 30-34 age group with 18.38, but the first and second wave were headed by the 55-59 age group with 5.04 and 5.68. Older people had a greater mortality rate, particularly in the age group over 80 years. In this population the mortality rate in the first and second wave was around five times higher than in the third one. Conclusions: In Peru, the second wave was the deadliest while the third one was the most infectious. Mortality was higher in men and older people.