Objective - To compare the risk of maternal death among foreign-born women with that of French women and to examine whether the quality of care received by women who died differs by nationality. Method - A national case-control study in France. The 267 cases were maternal deaths identified by the Confidential Survey of Maternal Deaths for 1996–2001. The 13,186 controls were drawn from the 1998 National Perinatal Survey. Results - After adjusting for confounding factors, the risk of maternal death was twice as high for foreign-born women: OR 2.0 (1.4–2.8). After adjusting for age, the OR was 5.5 (3.3–9.0) for women of Sub-Saharan African nationality, and 3.3 (1.7–6.5) for women from Asian and American countries. The risk of maternal death due to complications of hypertension and infection was four times higher among foreign nationals. Among deaths, care was more often suboptimal among foreign nationals (78% vs. 57%). Conclusion - Foreign nationality is associated with an increased risk of maternal death, which is particularly significant for certain nationalities and causes of death. Among maternal deaths, foreign nationality is associated with lower quality of care, suggesting that the increased risk of maternal death could be partly explained by factors related to care. (R.A.)