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Objective To assess the incidence of postpartum depression (PPD) and its risk factors in women with potentially life‐threatening complications. Methods Eight hundred and ninety women admitted to a tertiary center in South India with potentially life‐threatening complications were recruited for the study. Within seven days of delivery, women underwent mental health assessments using the EPDS and PHQ‐9 scale. Counseling was provided and follow‐up assessment carried out at 3 months postpartum. Bivariate and multivariate analysis was done to assess the association of risk factors to depression. Results PPD was observed in 21% of the study cohort. Women with no formal education (OR −2.66, 95% CI: 1.10– 6.40) and those who had a stillbirth (OR 2.48, 95%CI: 1.57–3.93) were found to be associated with PPD after adjusting for other factors. Occurrence of an obstetric near‐miss event did not increase the risk of depression. Most women recovered with postnatal counseling, with only three requiring medication at the end of 3 months. Conclusion One in five women who develop potentially life‐threatening complications developed PPD. A strategy of screening focused on this high‐risk group, especially in low resource settings, can lead to early recognition and treatment. This in turn can lead to a reduction in the long‐term morbidity associated with PPD.