Research Report Submitted to the School Of Public Administration and Management (SOPAM) as a Partial Fulfillment of the Requirement of the Award of Master of Health Systems Management of Mzumbe University.Every day in Tanzania a substantial number of women may be reported to have died on complication related to pregnancy or child birth-related. This situation prompted the researcher to conduct a study at Mount Meru Hospital (MMH) as a case study in order to examine the challenges that the hospital is facing in the wave of realizing reduced maternal mortality. A total of 102 respondents who were selected by simple random sampling technique were interviewed to solicit their views on the study. The gathered data were quantitatively analyzed by using SPSS and qualitative by using theme-content analysis approach and quoting the actual words of speakers. Data revealed MMR at MMH to be lower than the national MMR, which is 251 deaths per 100,000 live births. In addition, the study found out MMR at MMH to be contributed by overcrowding referrals, insufficient number of skilled maternal attendants, insufficient blood supply as well as poor recorded attendances to antenatal and postnatal services including inadequacy of beds. Some patients’ expressed their concern on the quality of maternal health service provided at MMH as being satisfactory (59%).It is from this study findings that the researcher had to conclude that the requirement for more and serious efforts to improved health system, awareness on obstetric care to pregnant women and other stakeholders, Strengthening of National Blood Transfusion program and creation of good working environment among the health providers.