Objective — to analyze the causes of maternal deaths in the Moscow Region in 1993—2013. Material and methods. A clinical and statistical analysis of 404 maternal deaths in the Moscow Region was made comparing the changes occurring during three 7-day periods: 1993—1999, 2000—2007, and 2007—2013. The changes in criteria, such as a reduction in obstetric beds; an increase in medical staff’s load; dead women’s age; a rise in the rate of extragenital diseases; reorganization of the region’s out- and inpatient obstetric/gynecological system; improvement of the material and technical base; emergence of novel methods and innovative technologies in obstetric facilities, were taken to compare maternal mortality rates during the given periods. Results. There was a stable tendency to decline maternal mortality rates that were 53.3, 37.3, and 15.9 per 100,000 live births in the first, second, and third periods, respectively. Conclusion. The analysis performed has indicated that there are social, medical, and organizational reserves to reduce maternal mortality in the Moscow Region, the use and implementation of which will be able to decline and stabilize this indicator as 8 cases per 100,000 live births in the region by 2020. The authors declare no conflicts of interest.