Maternal death is a woman’s death while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy. The maternal mortality rate (MMR) in South Africa is 88.0 per 100 000 live births, and in Mpumalanga province is 67.1 deaths per 100 000 live births. We conducted the study to evaluate the Maternal Death Surveillance and Response (MDSR) system.