Background: The International Classification of Diseases (ICD-10) defines maternal death as “the death of a woman while pregnant or within 42 days of the termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes”. Maternal Death Surveillance and Response is a means of availing information and in real time making maternal deaths visible events that beg for response. The objective of the study is describe the magnitude, causes and  trend of maternal death in south Wollo zone.

Method: Maternal death surveillance descriptive data analysis was done. A total of 84 maternal deaths reported weekly and through case based format during 2005-2010 e.c were included in the study. Data were entered into EPI INFO version 7 and then exported to SPSS version 20 for analysis. Results presented with tables and figures.

Result: the major causes of maternal death includes hemorrage (41.6%),sepsis (9.5%),obstructed labor (9.5%) anemia (7.1%) and HDP (5.9%).Trend of maternal death shows a decreasing pattern from 2005-2006,increasing from 2006-2009 but it shows slight reduction since 2010.

Conclusion and recommendation: Most of maternal deaths occurred in south wolo zone were home death .patricularly home death was highest in mekdela,legehida,saint,ambasel and wogdi woredas.Maternal death on transit was highest in ambasel woreda.

Interms of the timining of maternal death postpartum death accounts for the highest number of deaths.Most maternal deaths were preventable deaths. Type one delays were among highest contributing factors of maternal death.lack of transportation,delayed arival to the referal facility were highest type two delays.among type three delays delayed arival to next referal facility was highest in south wolo.

Health facilities Should avoid home delivery through maternal conference,stengthening traditional ambulance,postpartum follow up.