Background: Maternal mortality in Ethiopia is the fifth highest in the world, estimated to be 401/100000 population. Even though Ethiopia has been applying strategies to reduce maternal mortality such as Basic (BEmOC) and Comprehensive Emergency Obstetric Care (CEmOC), upgrading health facilities, training health officers and midwives, providing institutions with essential equipment, and regular monitoring and supervision, maternal mortality is still unacceptably high. The objective of this study is to explore factors associated with maternal deaths in the Wolaita Zone, Southern Ethiopia. Methods: The study used a grounded theory method with theoretical sampling. Four focus group Discussions (FGD) with 24 health care providers at four hospitals, and in-depth interviews with 10 family members of deceased mothers in Wolaita Zone who were identified from hospital records and from maternal death response officers and health extension workers in the district were carried out. All interviews and focused Group Discussion (FGD) were recorded, transcribed, and analysed using NVivo software with constant comparison analysis. Results: Grounded data from FGD and in-depth interviews revealed factors very likely associated with and contributing to the high maternal death from health care providers and deceased family perspectives. The Findings evolved as important were heavy bleeding, uterine rupture, delay in decisions to seek care, delay in getting to hospitals, and delay in receiving adequate health care. Conclusions: To reduce maternal mortality to Sustainable Development Goal (SDG) 2030 level, maternal complications found in this study along with others should be given critical emphasis from service users, health care providers and government.