Background:Mothers are the nurturing pillar of the family. When a woman dies, the consequences have the potential to affect not only the woman herself, but her family, society and the nation as well.In 2015 globally 303,000 women died of various causes related to maternity. Aim:To determine the Maternal Mortality ratio at the tertiary care hospital for a period of one year and to identify the causes and factors leading to Maternal mortality. Material and Methods:This was a retrospective observational study carried out in the department of Obstetrics and Gynaecology at Andhra MedicalCollege and King George Hospital, Visakhapatnam, which is atertiary care centre of North Andhra.The hospital runs one ICU and Obstetric HDU, one blood bank and emergency operation theatre round the clock to provide emergencyobstetric services and critical care to their patients.The female deaths which met the WHO Criteria for Maternal Death were included in this study.The details of all the maternal deaths from January 2021 toDecember 2021 were collected from the individual case sheets and facility-based maternal death review forms. Results:During the study period January 2021 to December 2021, therewere 18,892 live births and 86 maternal deaths. The MMR in thestudy period was 455.2/100,000 live births.The maximum number of maternal deaths was seen in the age group 20-25 years, 61 cases (70.93%).The number of maternal deaths were maximum in the low socioeconomic status group with 71 cases (82.55%). Type I delay was seen in 49 cases (56.97 %). Direct causes of maternal death in the study was due to abortion in 3 cases (3.4%), hypertension in 37 cases (43.02%), obstetric hemorrhage in 22 cases (25.58%), infection/sepsis in 21 cases (24.41%) and embolism in 3 cases (3.4%) The most common indirect cause of maternal death was anemia seen in 51 cases (59.3%) Conclusion:Hypertension, hemorrhage and sepsis continue to be the leading causes of direct maternal deaths and anemia indirect cause of maternal death. Majority of deaths are preventable and with proper strategies and focusing on the 3 delays, maternal deaths can be reduced.