Death certificates for all deaths in Iceland are available since 1911. In this report on maternal deaths, all women who died after the 28th week of pregnancy, during delivery and during the first eight weeks after delivery are included, irrespective of the cause of death. Out of 225 891 women who delivered during the 65-year period, 321 women died. Maternal deaths per thousand deliveries have declined from 3.89 to 0.09 from the first 5-year period (1911-1915) to the last 5 years of the observation time (1970-1975). The three main causes of maternal deaths, puerperal fever, haemorrhage and toxaemia, are discussed. Since the new Maternity Clinic at Landspitalinn opened in 1949 it has been the main department for obstetrics and gynecology in Iceland, to which a great majority of complicated cases in pregnancy and delivery are referred. Since 1949, 39411 women have delivered at this department. There have been 15 maternal deaths at the clinic or 0.4 per thousand. A separate table (Table III) shows the age, parity and causes of death in the 15 cases. Maternal deaths in Iceland during the last decade occur in one per 11 000 deliveries. This is a problem of communication as well as a medical problem.