Nepal has achieved remarkable improvements in maternal and newborn health despite geographic and resource challenges. With a maternal mortality ratio of approximately 174.4 deaths per 100,000 live births (down from 901 in 1990) and a neonatal mortality rate of approximately 17.0 deaths per 1,000 live births, the country shows significant progress. Skilled birth attendance has increased dramatically from 19% in 2006 to approximately 77%, reflecting successful policies including the Safe Motherhood Program providing cash incentives for facility delivery. Nepal faces extreme geographic challenges with communities across the Himalayan mountains, hilly regions, and lowland plains, creating diverse barriers to care access. The country has implemented innovative approaches to overcome these barriers, including approximately 2,000 birthing centers in remote areas and a strong female community health volunteer program providing basic maternal and newborn services. Nepal continues to address harmful traditional practices affecting maternal health, including chaupadi (menstrual seclusion) and dietary restrictions during pregnancy and postpartum. The 2015 earthquake highlighted infrastructure vulnerabilities, destroying many health facilities, though reconstruction efforts have strengthened disaster resilience. Recent initiatives focus on improving quality of care through the Safe Motherhood and Neonatal Health Program and addressing persistent disparities affecting Dalit and other marginalized communities, who experience significantly poorer maternal outcomes.