Abstract Background: Maternal deaths remain excessively high in developing countries, particularly in sub-Saharan Africa. In Nigeria, the Maternal Mortality Rate (MMR) ranged from 448 to 4210 per 100,000 live births with hypertensive disorders and haemorrhage as common causes. The aim of this study was to determine MMR and causes of maternal death in the Delta State University Teaching Hospital. Methods: A retrospective descriptive study was conducted at Delta State University Teaching Hospital, Nigeria (January 1, 2014 to December 31, 2018). The hospital deaths register was used as the starting point in the collation of a list of all maternal deaths and relevant maternal death medical records were retrieved and reviewed. The following information wasextracted: date of death, age, ethnicity, referring facility, place of death and cause of death. The STATA® 16.1 (StataCorp; College Station, USA) was used for statistical analysis. Results: There were 788 live births with a total of 57 maternal deaths resulting in MMR of 7,234 per 100,000 live births during the study period. The mean age of the women was 30.4 ± 7.3 years ranging from 15 to 46 years, with majority of women (53%) aged ? 30 years, 96% being referred and 18% delivered by caesarean sections. Overall, direct causes were responsible for 80% (n = 44) of all deaths, with hypertensive disorders in pregnancy 45% (25/55), medical/surgical conditions 15% (8/55) and obstetric haemorrhage 13% (7/55) being the most prevalent maternal cause of deaths. Conclusion: Maternal deaths are unacceptably high in this hospital, and associated with direct obstetric causes which include hypertensive disorders in pregnancy and haemorrhage. Improvement in quality antenatal care, timely identification of the cause of obstetric haemorrhage and access to blood products are an important intervention in the reduction of maternal deaths in this tertiary hospital.