Introduction– It has been estimated that up to 9 million women survive obstetric complications every year. Maternal near–miss refers to situations where women experience severe life–threatening obstetric complications during pregnancy, delivery or post pregnancy, which they survive either by chance or because they receive good care at a facility. Prevention of women‘s death related to pregnancy has been an international health and developmental priority today. This study is aimed to analyse near–miss cases at a tertiary care public hospital receiving mixed referral population. Materials and methods–A retrospective analysis was made regarding near–miss cases from December2016 to October 2018 at Chatrapati Shivaji Maharaj Hospital in Thane, Maharashtra. Quality of maternal health care was assessed via a newly developed WHO instrument based on near–miss criteria and criterion–based clinical audit methodology. Result–Around 13177 deliveries took place between December 2016 and October 2018. Out of 13177, 141 were near–miss cases and 23 maternal mortality cases. Majority of the near–miss cases were multigravida. Maximum number of cases of near–miss were due to ruptured ectopic pregnancy (24/141) followed by severe PIH, placenta previa, abruption placenta and eclampsia (17/141 each). 73 out of 141 cases underwent LSCS i/v/o previous LSCS or eclampsia or abruption. There were 11 cases of obstetric hysterectomy following massive post–partum haemorrhage or infection or rupture uterus. Around 100 patients had to be transfused blood or blood products and 116 out 141 patients had coagulation failure. Conclusion–Maternal mortality is the tip of the iceberg, there is a large base of the severe acute maternal morbidity, the identification and analysis of which will tell the true story of the complications. Thus, analysing near–miss cases will help in assessing the quality of health care services provided and also in suggesting the improvement needed at each level of care. This will also help us in understanding the progression of diseases that may lead to maternal death and thus, taking appropriate steps in preventing one.