Low- and middle-income countries (LMICs) bear the burden of maternal-fetal and women’s health morbidity and mortality, despite growing global attention. Every year, approximately 350,000 women in the world die while pregnant or giving birth, up to million newborns die within their first year of life, and there are 2.6 million stillbirths. Each day, 3500 women experience birth complications, while another 800 women die from preventable causes related to pregnancy and postpartum. Examination of the published epidemiologic data from around the world reveals unique characteristics and dissimilarities of countries with high maternal mortality. This chapter examines the scope of morbidity and mortality for women of reproductive age and their offspring, with special attention to conditions that can be diagnosed by ultrasound imaging, the most widely used form of imaging in women’s health and obstetric care. An overview is presented on the impact of regional, legal, and sociopolitical customs in target communities on practice of prenatal ultrasonography and how obstetric imaging may play a crucial role in reducing maternal and perinatal mortality. Published outcomes of projects using trained indigenous healthcare providers in the use of ultrasound are promising. With increasing availability of ultrasound technology, the replication of these prototype projects (coupled with other social and educational changes) could lead to improved maternal-fetal outcomes.