She was the youngest child and fifth daughter of Louis IV, Grand Duke of Hesse and by Rhine, and Princess Alice of the United Kingdom.

When she was a baby, her mother remarked in a letter that "little sister Maly" bore a strong resemblance to her dead brother Friedrich ("Frittie") at the same age "with such quick eyes and two deep dimples in her cheeks."

A few weeks later, Alice wrote that baby "Maly" had fair skin, light brown hair and deep blue eyes.

Sending photos taken then to her mother, Queen Victoria, Alice wrote that "May has not such fat cheeks in reality; still it is very dear.

As her sister Victoria described the scene later, the family had been gathered together on the evening of 5 November when she developed a stiff neck.

[5]Victoria felt well enough to read Alice in Wonderland to her younger siblings, while her mother sat nearby chatting with her friend, Katie Macbean, who was filling in for an absent lady-in-waiting.

Grand Duchess Alice ordered that a steam inhaler should be brought to her room to prevent the seriously ill Alix from choking to death.

Grand Duchess Alice sat by her daughter's body, kissing Marie's face and hands, trying to work up the strength to tell her ill husband.

[7] For weeks, Grand Duchess Alice concealed Marie's death from the other sick children, who asked about her and tried to send their little sister toys.