The problem of urban shrinkage is emerging in Korea due to population decline and aging. Existing research on urban shrinkage mainly deals with the reduction of the city's total population, and it is difficult to find research on population decline in microscopic spatial units, called the urban perforation phenomenon. Accordingly, the purpose of this study is to analyze areas where urban perforation has occurred and to analyze influencing factors in small and medium-sized cities in Korea. The spatial scope of the analysis is 19 small and medium-sized cities, and the temporal scope of the study is from 2010 to 2021. The urban perforation occurrence areas were derived using a 500m x 500m grid. Afterwards, a type was derived through K-mean cluster analysis, and influential factors were analyzed through a binary logistic model. The results of the study are summarized as follows. First, the areas where urban perforation occurred were divided into five types: areas with good service (low density), studio apartment areas, low-density old areas, central places in suburban areas, and newly developed areas. Second, as the elderly population ratio, the proportion of buildings older than 35 years, and the distance to expansion areas increase, the probability of urban perforation occurring increases. Third, as the total population, youth population ratio, number of buildings, total floor area, number of apartment houses, presence of public administrative center, presence of elementary school, distance to railway station, and built-up area ratio increased, the probability of urban perforation decreased.