The causes of sudden cardiac death are diverse, and are a function of age. In adults, coronary atherosclerosis and acquired forms of cardiomyopathy, Cardiac arrhythmia, myocardial infarction are the most common findings at autopsies of sudden cardiac death. Almost all sudden cardiac death investigations require correlation of circumstantial data with autopsy and laboratory data. A complete autopsy, including detailed neuropathological and cardiovascular examination with toxicological studies, must be performed in the context of all available clinical information and of the circumstances of death, thus excluding noncardiac causes and discovering those that are cardiovascular in origin but not related to coronary causes. A detailed protocol is presented for a practical use in suspected cases of sudden cardiac death. Histology may offer structural details of the cardiac wall and coronary intraluminal changes, particularly when serial section studies are performed.