Maternal mortality rate due to pregnancy and delivery complications is one of the significant health indicator and health care in the community. Because of complications and mortality of pregnancy are preventive, thus we must investigate and comparison of direct maternal mortality causes and increase or decrease. The aim of this study was to analyze the causes of direct maternal death and to measure the maternal mortality rate. All cases of direct maternal death were investigated during 10 years (1370-1379) at the Gynecology and Obstetric wards and ICU of the Emam Reza hospital in Mashhad and results included the following. During the years of 1370-1379, there were 31 direct maternal deaths and the maternal mortality rate was 88 in 100000 live births. The most common causes of direct maternal mortality were Hemorrhage (58%), Eclampsia (25.80%), Amniotic Fluid Emboli (9.7%), and Infection (6.5%). Abundance of maternal mortality decreased in different years except in 1373, 1376, 1378when it increased and the increase was seen in the data of total maternal mortality in these years in Khorsan province. The highest percentage of maternal mortality occurred in 35-39 age spans (25.8%) and the lowest in 40-45(9.7%). The most maternal mortality happened in multiparty more than 6 pregnancies. In this study, 61.5% of mothers were rural. Thus improvement of the health and prenatal care, control and treatment of high risk pregnancy , health education to the total community especially pregnant women, suitable nutrition for pregnant women, training midwives and sending them to the faraway areas and to support family planning decrease the maternal morality and morbidity, improving the pregnant mothers' health