Objective: To determine the adverse events association with extreme maternal morbidity and maternal mortality of women treated in a high complexity obstetrics unit of Manizales 2015 - 2016. Methodology: Cases and controls study. Signs of unsafe care were sieving, and the presence of the adverse event was evaluated by clinical and quality experts. The confirmed events were submitted to evaluation of quality attributes violated in the care, their severity was determined and it was identified if it was analyzed by the participating institution. The statistical analysis was according to the nature of the variables and the calculation of raw OR ratio and their corresponding confidence intervals to establish the association between the study variables. Results: There is a statistically significant association between adverse events and extreme maternal morbidity and maternal mortality, with a probability of occurrence of EA 21,3 times higher in cases than in controls (OR 21.36 [2.79; 163.12]; p = 0.000). There is a relationship between the violation of the opportunity quality attributes (OR 4.78, 95% CI [1.32, 17.3]; p = 0.009) and safety (OR 25.77, 95% CI [3.36; 195.4]; p = 0.000) with the extreme maternal morbidity and maternal mortality. A fewer hospital stay is a protective factor for not suffering MME or mortality (OR: 0.040 95% CI [0.020; 0.08] p = 0.000). Conclusion: Indeed, there is a difference in the history of exposure to adverse events in cases compared to controls, therefore the null hypothesis is rejected.