Respiratory distress is the most common complaint of obstetric women admitted to ICU. The incidence of acute respiratory distress in pregnancy necessitating mechanical ventilation is 0.1 to 0.2%. This study was planned to identify risk factors and diseases which lead to ICU admission in respiratory distress and morbidity and mortality associated with these women. All antenatal women with respiratory distress after 20 weeks of gestation and after delivery up to 6weeks who required intensive care and were shifted to ICU included in the study. The majority of women in the present study were in age group 21 to 30 years, multiparous, and from a rural background. Respiratory distress predominantly occurred in women in the antenatal period, 35.24% were in the postpartum period. The mode of delivery was caesarean section is 48 (60.75%) women and only 16 (20.25%) women delivered vaginally.All causes of respiratory distress were categorized into Obstetrical (61.47%) and Non-obstetrical (38.52%) causes. The obstetrical causes were pre-eclampsia (44%), eclampsia (25.33%), postpartum haemorrhage (8%), hemoperitoneum 2.66% (one with splenic rupture, one with coagulation dysregulation), placental abruption (6.66%), twin pregnancy (10.66%) and obstructed labour (2.66%). The non- obstetrical causes were included sepsis 19 (40.42%), respiratory disease (23.40%), heart disease 5 (10.63%%), Jaundice 7(5.73%), Dengue shock syndrome (4.25%), seizure disorder (4.25%) and guillain barre syndrome (2.12%). Respiratory distress and ICU admission are one of the key indicators of maternal morbidity and mortality. To reduce maternal mortality, it is essential to identify risk factors earlier in pregnancy and further strengthening of the healthcare system from head to toe, starting from primary healthcare units to tertiary healthcare services including ICU facilities.