Maternal mortality remains a serious threat especially to developing countries. We proposed to determine the frequency, causes and contributing factors to maternal mortality in order to improve the quality. of care. This is a retrospective study on 138 cases from 1 January 2005 to 31 December 2008 at the Maternity Center Hospital Régional of Ségou. The maternal mortality rate was obtained in 2031 for 100000 live birth. The causes were dominated with obstetric hemorrhage (38.4%), anemia (26.8%), hypertensive complications (20.2%), infections (13.0%). Risk factors such as age, parity, without the occupation, the non-educated; associated with delayed evacuation and the lack of the technical burden contributed to the clinical picture of our patients. The issue of maternal mortality calls everyone of us, mainly health staff. Its reduction passes by a coordinated and effective action on all the levels of care in pregnancy and childbirth.