Aim: The aim of this study is to Study on Severe Acute Maternal Morbidity in patients attending Sultania Zanana Hospital, Bhopal. Study Design: Observational Study. Result: Among all the cases of SAMM maximum 66.2% were in the age group 20–30 yrs. This is due to the fact that 20–30 yrs is the most fertile period of a woman’s life. Maximum cases i.e. 95.96% were unbooked emergencies. The strong positive association between level antenatal care obtained during pregnancy and degree of severe acute maternal morbidity. Primigravidas were 25.8%, 61.29% were multiparas, and 21.9% were grandmultiparas. Hemorrhage was the leading cause of severe acute maternal morbidity in our setting accounting for 62.9% of the cases, followed by hypertensive disorders of pregnancy representing 20.16% of total cases. Conclusion: The most common reason for SAMM was Hemorrhage of which ruptured ectopic pregnancy emerged out to be the commonest obstetric factor followed by eclampsia among hypertensive disorders of pregnancy. Reduction of maternal deaths in this centre therefore requires channeling of resources towards the prevention of hemorrahage & hypertensive disorders at the lower level of health care system while strengthening the resources for their treatment in the tertiary care hospital. This implies maintaining & improving the existing preventive measures & treatment strategies for early identification of ectopic pregnancy, for eg use of transvaginal sonography & improving the protocols & resources for managing it. Necessary facilities should be made available and training of doctors in both basic and emergency obstetric care should be frequently conducted to combat the identified disease processes that received suboptimal care during pregnancy.