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Objectives: To investigate and determine the causes of maternal near miss cases (MNM) and maternal deaths (MD) in our hospital set up. The major reasons and causes for MNM and MD are the same. So investigating the cases of MNM may yield valuable information regarding severe morbidity, which could lead to death of the mother, if timely intervention does not take place. Methods: This was a prospective observational study conducted from 1st January 2014 to 31st December 2015. Obstetric complications were analysed. Prevalence of maternal near miss (prevalence ratio), maternal near miss incidence ratio (MNMR), mortality index, maternal near miss to mortality ratio were calculated. Results: There were 3375 deliveries, 3340 live births, 114 MNM cases and 5 maternal deaths during the study period. Hypertensive disorders of pregnancy (38.5%) were the commonest causes of MNM cases. Haemorrhage accounted for 29.8% cases of MNM. The MNM ratio was 32.63% and maternal mortality ratio was 149 per 1, 00,000 live births. Conclusion: Hypertensive disorders of pregnancy and haemorrhage were the leading causes of MNM cases. All the near miss cases should be interpreted as opportunities to improve the quality of health care services.