OBJECTIVE To characterize the maternal mortality in the state of Mississippi for 1987-1991 and compare the maternal mortality from 1977-1986 with that of the last 5 years. METHODS Factors associated with maternal mortality were obtained from death certificates, replies to questionnaires, medical records, and autopsy reports. RESULTS The maternal mortality rate in Mississippi for 1987-1991 (14.1/100,000) was not significantly different than for 1977-1986 (11.8/1000,000; P = 0.45). Over the last 5 years there was an increased incidence of direct obstetric deaths (50% vs 73%). During 1987-1991, toxemia as a cause of death for parturients decreased, while hemorrhage as a cause of maternal death increased. There was a rise in the incidence of patient related factors which were avoidable and which led to several deaths during 1987-1991. CONCLUSIONS The state's maternal mortality rate remains stable. Improved patient and health care provider's education are necessary to further decrease the incidence of maternal death in Mississippi.