Objective: Lack of access to quality emergency obstetric care (EmOC) contributes to high rates of maternal and neonatal morbidity and mortality in resource-poor nations. Thus, this study evaluates the impact of an EmOC training program on maternal and neonatal sepsis outcomes across India. Methods: Case records were analyzed for sepsis, antibiotic utilization, managed cases, and maternal and neonatal outcomes from 10,558 reported deliveries between 2006 and 2012 at twenty-three district hospitals across seven states. Results: Of the 155 identified cases of sepsis, (116 maternal and 39 neonatal), 40% were independently managed by those trained in the EmOC program and did not result in the referral of the patient to a higher center. Antibiotics were used to treat 10.9% of cases. Among patients (89.1%) who did not receive antibiotics, there were 5 maternal deaths (3.6%) and 3 neonatal deaths (2.3%). Managed cases were associated with a greater ratio of antibiotic use and lower sepsis-related mortality. Conclusion: Training nonspecialist physicians in EmOC and proper identification and treatment of sepsis could greatly improve the outcomes of patients with sepsis in India. Increasing antibiotic availability and consistent and accurate reporting of sepsis cases could lead to a marked decrease in maternal and neonatal mortality. However, systemic underreporting of sepsis cases limit the generalizability of these findings.