Maternal mortality rate is an indicator that reflects the health status of mothers, especially the risk of death for mothers during pregnancy, childbirth, and postpartum. Every year an estimated 529,000 women in the world die as a result of complications arising from pregnancy and childbirth, so an estimated MMR of 400 per 100,000 live births. This means that one woman in the world will die every minute. Aims: To have an overview of changes in maternal mortality rates based on direct and indirect causes from 2006-2023 in Cirebon City. Methods: This is a retrospective descriptive study with total sampling. Samples were taken through observation of data taken in the form of secondary data and maternal audits on mothers who died during pregnancy, childbirth, and postpartum period at the Cirebon City Health Office from 2006 until 2023. Results: There were 64 maternal deaths based on direct causes 40 deaths and indirect causes are 24 deaths. Based on the causes of maternal death, the most due to direct causes were bleeding 12 deaths (30%), eclampsia 12 deaths (30%), hypertension 9 deaths (23%). She was followed by indirect causes, namely COVID-19 as many as 12 deaths (50%) and cardiovascular disease 11 deaths (46%).  Conclusion: Throughout the period 2006-2023 maternal deaths due to direct causes, such as bleeding, eclampsia, and hypertension tend to be the most frequent causes of maternal death. While the indirect causes are dominated by cardiovascular causes and COVID-19.