Objective: To investigate racial disparities in maternal mortality rates and prenatal care in Brazil from 1996 to 2022, focusing on differences between white and non-white women, and to assess the impact of systemic racism and healthcare inequities on these disparities. Design: Retrospective cohort study analysing maternal mortality rates, adjusted lethality percentages, and prenatal care consultations over a 27-year period. Setting: Brazil, using national public health records (DATASUS). Population: Women aged 15 to 44, with data categorized by racial groups—white and non-white. Methods: Maternal mortality rates per 100,000 live births and adjusted lethality percentages were calculated and examined using trend analysis. The Mann-Kendall test was used to assess the statistical significance of trends over time. Prenatal care adequacy was evaluated based on adherence to recommended protocols. Main Outcome Measures: Maternal mortality rates, adjusted lethality percentages, and the adequacy of prenatal care, segmented by race. Results: Non-white women consistently experienced higher maternal mortality rates, ranging from 0.57 to 1.10. Maternal mortality among white women declined significantly (p = 0.007), while the decline for non-white women was not significant (p = 0.526). Adjusted lethality rates decreased overall, but non-white women had persistently higher rates. Prenatal care improved over time, yet white women received more adequate care than non-white women. Conclusions: The study underscores enduring racial disparities in maternal mortality and prenatal care in Brazil, reflecting systemic inequities and structural racism. Despite overall improvements in maternal health indicators, significant disparities persist, particularly affecting non-white women. Funding: None.