A three year maternal mortality survey in Saudi Arabia has identified the various epidemiologic risk factors for maternal deaths. Unbooked, uneducated and economically underprivileged females were at increased risk of maternal death, especially >para 7 females, who were found to be at increased risk of maternal death, particularly deaths due to hemorrhage, pulmonary embolism and uterine rupture. In Saudi Arabia, there are contradictory risk factors for maternal death; e.g. low female literacy rate, early marriage and unregulated high fertility, and affluence which has brought about improvements in all walks of life including health services. Increasing the number of booked patients, especially among the elderly grand multipara, improving the quality of emergency obstetric services and achieving a higher female education rate are likely to bring the present maternal mortality ratio (MMR) of 18 per 100,000 births down to a minimum. The MMR obtained in this study compared favorably with those of the oil-producing Gulf countries and the developing and developed countries of the world.