This handbook aims to describe the indicators and to give guidance on conducting studies to people working in the field providing emergency obstetric care. It includes a list of life-saving services, or ‘signal functions’, that define a health facility with regard to its capacity to treat obstetric emergencies with the emphasis on actual rather than theoretical functioning. The emergency obstetric care indicators described in this handbook can be used to measure progress in a programmatic continuum: from the availability of and access to emergency obstetric care to the use and quality of those services. This is an update of an earlier publication on monitoring the availability and use of obstetric services published in 1997 which was used in over 50 countries. This version includes two new indicators and an additional signal function, with updated evidence and new resources.