Introduction: According to WHO Maternal "Near miss is said to have occurred when a women who nearly died but survived a complication that occurred during pregnancy, child birth or within 42 days of termination of pregnancy". A retrospective, cross sectional study of 15,625 live births were studied for Near Miss case study at Sri Chamarajendra Government MCH tertiary referral centre Hospital attached to Hassan institute of Medical Sciences, Hassan, Karnataka. The prevalence, maternal and fetal outcome were analyzed statistically. Methodology: A retrospective analysis of 15,625 live births over a period of 2 years, March 2018-march 2020. The observations among Near Miss cases such as demographic profile of subjects, co-morbidities associated with pregnancy, mode of delivery, causes of maternal morbidity and mortality, icu transfer rate, Mean Duration of hospital stay, average Out of pocket expenditure ,Neonatal outcome were statistically analyzed. Observation: 34 Near miss cases were analyzed in this study was 2.2/1000 live births, maternal near miss to mortality ratio was 3.7:1, Mortality index was 20.9%,caesarian delivery rate 48%, causes for Near Miss being hemorrhage 85.2%, Hypertention-11.7%, others 3.1%, 29.4%women did not have any preexisting causative illness nor co-morbidities. Neonatal outcome being-preterm-5.88%, IUFD-17.6%, Low Birth Weight-7.8%, abortion-14.7%., ICU transfer rate-9.6%, mean duration of hospital stay---7.5 days, with low out of pocket expenses Conclusion: Hemorrhage, (Postpartum Hemorrhage) remain main cause of maternal near miss cases, which may be often predicted. Prompt detection, early referral to tertiary centre for timely intervention and early treatment of causes may improve obstetric outcome and prevent Near Miss catastrophe.