OBJECTIVES: Primary health centers (PHCs) are important source of maternal health services in India. The average maternal mortality ratio in India is 178 per 100,000 live births. This study aims to find out whether the drugs and equipment in PHCs are adequate according to Indian Public Health Standards and whether there is any effect of their availability on maternal mortality. METHODS: The study was conducted in 3 districts of Andhra Pradesh state of India. 30 PHCs were selected in each district using simple random sampling. 90 PHCs were visited and data was collected. The study was done between May 2012 and April 2013. Maternal mortality data was obtained from records of each primary health centers for the year 2012-2013. Regression analysis using Maternal Mortality as dependent variable and availability of essential drugs and equipment as independent variables is done. RESULTS: Only 30% of PHCs had an emergency obstetric drug tray consisting of all the essential drugs. Only 60% of PHCs had labor table and Suction machine. Oxygen administration facility was available in 40% of PHCs and sterilization equipment in 50%. Normal delivery kits were available in 90%, while complete assisted delivery kits were present in less than 10%. Average maternal mortality in surveyed PHCs was 97/100,000 live births. For every unit increase in availability of Emergency Obstetric kit with all 6 contents, maternal mortality decreased by 8/100,000 live births and for the availability of a fully equipped sterile labor room, the maternal mortality decreased by 11/100,000 live births. CONCLUSIONS: PHCs in India show poor availability of essential drugs and delivery equipment even after 5 years of full implementation of IPHS of National Rural Health Mission. Availability of emergency obstetric drugs and supplies significantly reduce maternal mortality. India should ensure continuous availability of emergency obstetric drugs, supplies and equipment for rapid improvements in maternal mortality.