Based on the UN Millennium Development Goals (MDGs) indicators and the Multiple Indicator Cluster Survey (MICS) for 2009, we report the current status and challenges of maternal and child health in North Korea. We report that for the last 20 years maternal and child health status in North Korea has remained at a similar level without much progress. The proportion of mothers and children who experienced malnutrition is disturbingly high. Regional disparities between urban and rural areas are common. Due to a number of reoccurring barriers, prospects for MCH programs, in which continuous care is the key factor for a successful operation, are not bright in North Korea. We recommend international guidelines, procedures, and monitoring-and-evaluation (M&E) frameworks be used as practical references for MCH in North Korea.