Background: Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. For identifying near–miss cases five–factor scoring system was used. In 2009 WHO working group has standardized the criteria for selecting these cases . Methods: The study was conducted in the Department of Obstetrics and Gynecology at Guru Gobindsingh Government General Hospital, Jamnagar, Gujarat, India, which is a tertiary care centre. For each case of near miss, data were collected on demographic characteristics including gestational age at the time of sustaining the near–miss morbidity, nature of obstetric complications, presence of organ–system dysfunction/failure, ICU admission and timing of near–miss event with respect to admission. Results: During the 1 year of the study period, 7700 deliveries at the institution and 316 women were identified as near–miss obstetrical cases. Near–miss per 1000 delivery was 41. The leading causes of maternal near miss were hemorrhage (47%) and hypertensive disorder of pregnancy (29.4%). The morbidity was high in unbooked cases. Conclusions: Maternal near miss is good alternative indicator of health care system.