This cross sectional study was done in Gopalganj district from September 1997 to August 1998. To ascertain the magnitude and causes of maternal deaths and perinatal and neonatal outcome of the babies. Two hundred five in maternal deaths occurring from 1994 to 1997 were investigated by verbal autopsy. Teenager mothers had more deaths in first pregnancy. Maternal deaths increased with gravidity above 30 years. Haemorrhage and eclampsia were common causes of death. Eclampsia was prominent in primigravids <20 years while haemorrhage occurred more in multigravidas between 25-35 years of age (P = 0.029 for age, P = <0.001 for gravidity). Nearly 64% of maternal deaths occurred in postpartum period. Among live births, 45.6% babies died before their first birth day. The findings support the need of increasing the age of marriage and first childbirth, through strengthened family planning programme and ensuring skilled birth attendance during delivery. It also stresses need for communication on danger signs of pregnancy and childbirth.