Background: Analysis of maternal near miss provides a good opportunity for assessing the factors responsible for maternal mortality in this area. Objective: Incidence of maternal near miss and mortality cases in central India tertiary care centre and evaluation of various causes using WHO criteria. Material and Methods: It is an ongoing prospective observational study conducted in the department of Obstetrics and Gynaecology, Index medical college, Indore, MP from September 2015 to October 2016. The patients who fulfilled the WHO criteria of maternal near miss were enrolled; their clinical and investigation parameters were recorded. Results: During the study period a total 4786 deliveries were observed, out of that 4533 were live births, 74 were near miss cases and 15 maternal deaths. Twenty nine (39.1%) of near miss cases were found in 15-20 year of age group while 53.33 % cases of maternal death were found of same age group. Primipara cases were more in both near miss (60.8 %) and maternal death group (60.0 %). Majority of patients were in third trimester and underwent vaginal delivery. Among the causes of near miss events, hemorrhage was the leading cause followed by preeclampsia/eclampsia and sepsis. Conclusion: Near miss cases generally occur more frequently than maternal death and therefore a more reliable quantitative analysis can be carried out, which can provide more comprehensive profile of health system functioning. Identification of the obstacles and gaps in the health system and a coordinated approach to resolve these can ultimately lead to an improved health system.