The 2020 annual report of the Maternal and Newborn Health Thematic Fund (MHTF) highlights UNFPA's key strategies and achievements within the context of the COVID-19 pandemic – a global crisis that has overwhelmed health systems across the globe and severely impacted the global health workforce. Within this challenging environment, the MHTF continued to rise to the challenge, with a strong focus on promoting equity in access, universal health coverage, and improving accountability and quality of care. The MHTF continued to support 32 high-priority countries to ensure that past gains in integrated sexual, reproductive, maternal and newborn health and rights are safeguarded and that pandemic recovery measures prioritize these essential services. The report shows furthermore how efforts to save and improve the lives of women and newborns can be effective even during a global health crisis. The report highlights the need for such efforts to be comprehensive and rights-based, so that the most vulnerable in society can continue to access the quality services they need. While the full measured impacts of the pandemic are not yet known, strengthening midwifery, Emergency Obstetric and Newborn Care networks, Maternal and Perinatal Deaths Surveillance and Response programmes and the path to fistula eradication continue to be crucial to building resilient health systems.