Objective: To review the changing trends in maternal mortality rates and causes of maternal deaths. Methods: This is a retrospective analysis of maternal deaths occurring over a decade from 1998 to 2008 carried out at the department of Obstetrics and Gynecology, M.S. Ramaiah Medical College, Bangalore, which is referral tertiary center catering to high risk pregnancy care.. The data has been analyzed in two comparable time frames from September 1998 to August 2003, and September 2003 to August 2008. Results: The MMR / 100,000 live births has shown a decrease from 1066 in 1998-2003, to 931 in 2003- 2008. 56-61% of deaths across both groups occurred in primigravidas.