BACKGROUND: - Maternal deaths have always been a challenge worldwide. Autopsy based study in cases of maternal mortality serves as an indispensable tool to analyse causes of maternal mortality. AIMS: - To study incidence of varying direct causes of maternal deaths. To study the precedent risk factors and analysis of direct causes of maternal deaths with variables like age, trimester of pregnancy, gravidity, duration of hospital stays, etc. To compare clinical diagnosis with autopsy diagnosis. DESIGN: This study is retrospective observational study over 6 years and 1 year of prospective observational study in the department of Pathology at a tertiary care centre. MATERIALS AND METHODS: - Autopsy records of 75 maternal mortality cases where pathology autopsy was performed in this period were studied. The available gross specimens and histopathology slides were retrieved and studied. RESULTS: - Most common direct cause of maternal death in this study was found to be peripartum dilated cardiomyopathy (26.65%), followed by DIC (14.6%). Maternal deaths were found to be more prevalent in age group 21-25 years (32.42%), multigravida & multiparous. Most of the maternal deaths were in postpartum period (57.76%) and in third trimester (6.46%) if antepartum, with vaginal mode of delivery. Hospital stay was between 24 hours to 1 week. CONCLUSION: -Peripartum dilated cardiomyopathy was most common frequent maternal death in this study. Since the most frequent etiologies that lead to maternal death are preventable, more autopsy studies can be of great help in eliminating these.