Background: Present study was aimed to study clinical course, outcome and causes of mortality among obstetric patients admitted to post anaesthesia care unit at a tertiary hospital. Material and Methods: Present study was hospital based prospective observational study, conducted in obstetric patients (antepartum beyond 20 weeks of pregnancy up to 6 weeks of postpartum) who undergone surgical intervention and needs PACU admission. Results: Majority of the patients were in the age group of 21-25 years (52.4%), mean age of the patients was 24.68 ± 3.82 years. The mean duration of ICU stay was 5.31±2.25 days in our study. The mean SAPS II score was 55.26±18.52. The most common indication for post anesthesia care unit (PACU) admission was hemorrhage (36.2%) followed by hypertensive disorder of pregnancy (31.4%) & cardiovascular diseases (17.1%). The clinical course of management included mechanical ventilation (73.3%), inotropes for (44.8%), transfusion of blood and blood products and ICU intervention (27.6%). 77 (73.3%) patients were discharged while 28 (26.7%) patients died in our study. The main cause of maternal death was Multi-organ Dysfunction Syndrome (MODS) (68.1%), followed by Disseminated Intravascular Coagulation (DIC) (17.6%), cardiorespiratory arrest (10.7%) and septic shock (3.6%). The Duration of ICU Stay (5.83 ± 1.98 days vs. 3.89 ± 2.39 days; p<0.05) SAPS II Score (63.09 ± 14.57 vs. 33.71 ± 8.18; p<0.05) was significantly higher in discharged patients compared to died patients. The requirement of inotropes (28.6% vs. 89.3%; p<0.05) and transfusion of blood and blood products (19.5% vs. 60.7%; p<0.05) was significantly lower in discharged patients compared to died patients. Conclusion: Full adoption of safe motherhood initiative that is close observation of pregnancy, improvement in antenatal care, early identification of complications, outlining protocols for admission to ICU will be a major step to decrease maternal morbidity as well as mortality.