Objectives - To compare the incidence of maternal mortality (MM), causes of death, characteristics of deceased women, and the quality of care provided across three geographic areas: the overseas departments (DOM), Île-de-France (IDF), and other regions of mainland France. Methods - Descriptive study of maternal deaths identified by the confidential national survey on maternal deaths from 2001 to 2006. Crude and age-standardized MM rates were compared, as were cause-specific rates and the quality of care. Results - After age standardization, the maternal mortality rate is higher in IDF (1.7 times higher) and in the DOM (4.3 times higher) than in other metropolitan regions. These differences persist after adjusting for the women’s nationality. Hemorrhage is the leading cause of maternal mortality in the Paris Region (16.8%) and in the French overseas departments (20.6%), whereas in other regions of mainland France, indirect obstetric causes are the most frequent (statistically different distribution, p<0.01). Among the deaths, care was judged to be suboptimal more often in the Paris Region (75%) than in other regions (60%) (p=0.03). In the French overseas departments, care was suboptimal in 53% of deaths. Conclusion - Regional disparities in maternal mortality exist in France, both in terms of maternal mortality rates and causes of death. Neither the age nor the nationality of women explains the increased risk of maternal mortality in the Paris region and the French overseas departments. (R.A.)