Background: Severe acute maternal morbidity has long-term ill effects on socioeconomic condition and health of the females including excessive financial burden post-treatment which may last lifelong to the desertion of females after hysterectomy considering the inability to reproduce. Aims: The present clinical trial was carried out to assess the incidence and various causes leading to SAMM. Also, the trial was aimed at factors associated with the instance of nearmiss cases or SAMM. Materials and Methods: 82 SAMM cases and 4 maternal deaths were evaluated based on the WHO criteria. The data were maternal deaths, demographic data, complications encountered, gestational age at the time of SAMM, SAMM event time from admission time, ICU admission, and associated organ failure/dysfunction. The collected data were subjected to statistical evaluation and the results were formulated. Results: Maternal death resulted from abdominal pain in 75% (n=3) and breathlessness in 25% (n=1) female. The disorders associated with SAMM were surgical cause, haemorrhage, hypertension, indirect causes, and medical conditions respectively in 1.21% (n=1), 32.92% (n=27), 63.41% 9n=52), 2.43% (n=2), and 18.29% (n=15) females. The etiology of 4 deaths was due to 50% (n=2) deaths each from cardiac and respiratory etiology in females with the gestational age of 30.10±2.14 weeks and 25.7±1.3 years of age. Near-miss cases were 34.14% (n=28) due to compromised transport facility. Conclusion: The present study concludes that severe acute maternal morbidity affects significant females and is the leading cause of maternal death. The most common factor associated with SAMM is in the present study was hypertension leading to morbidity followed by hemorrhage, whereas, leading causes for morbidity were respiratory and cardiac causes.