Background: Severe Postpartum Haemorrhage (PPH) is one of the major complications following childbirth. Many interventions have helped to reduce its impact on maternal outcomes, nonetheless, it remains one of the major causes of maternal mortality. This study, therefore, aimed to determine the factors associated with mortality in severe PPH compared with those women who survived after experiencing severe PPH in Mzimba District, Malawi. The findings could help to strategize appropriate interventions to manage women at higher risk of mortality from severe PPH. Methods: A case-control approach using secondary data from women who had severe PPH was used. Stratified random sampling was used to select the cases and controls and Statistical Package for the Social Sciences was used to calculate the odds ratio and chi-squared test. Results: The factors that were associated with mortality in severe PPH included the age range of 35 years and above (OR=5.69) rural dwelling (OR=3.83), (pre)eclampsia (OR=6.14), gravid 5 and above (OR=3.08), para 5 and above (OR=3.30), cesarean section delivery (OR=3.03) and poor neonatal outcome (OR=10.86) while the protective factors included spontaneous vaginal delivery (OR=0.30), perineal tears (OR=0.27) and uterine atony (OR=0.24). Conclusions: The finding identifies some of the risk factors associated with mortality in PPH. It, therefore, indicates the need for comprehensive preventive measures and practices among those with risk factors to further reduce the maternal mortality associated with PPH and thereby leading to the achievement of Sustainable Development Goal 3.1.