Introduction Recently, Iran has experienced a rapid improvement in socio economical status and improved to upper-low economic countries. The trend of maternal mortality rate (MMR) as one of the main indicators for development and health has been reviewed systematically from 1970 to 2007.

Methods A systematic search was performed in PubMed, Embase database, Cochrane library, WHO-EMR Library and local medical databases to identify all articles and reports on the MMR in Iran. Well qualified documents were selected for data extraction and Meta analysis. Weighted linear regression was applied for exploring the trends.

Results For the 5-year intervals between 1970 and 2007, MMR was estimated as 237, 140, 100.3 (95% CI 83.65 to 117.00), 54, 56.2 (95% CI 39.72 to 72.70), 40.6 (95% CI 21.70 to 59.65), 24.1 (95% CI 20.66 to 27.67) per 100 000 live births. MMR has been decreased by 40 per decade. The most heterogeneous factors were the year of the study/report and the type of the report (from inside or outside of the country).

Conclusion It's obvious that the MMR trend was significantly downward in recent decades. And it's expected with such trend, Iran will achieved the millennium development target at 2015. Although the decreasing rate is considerable among the developing countries; however, it is comparable to the increasing rate of developed countries in 1920s–30s. More reduction in MMR is achievable only other related factors such as health social determinants are considered.