Objective: To assess the medicolegal causes of asphyxial deaths in tertiary care hospital of Hyderabad, Sindh, Pakistan.

Study Design: Descriptive, observational and retrospective

Place and Duration of Study: Medicolegal Section of Liaquat University Hospital Hyderabad from 1st January 2015 to 31st December 2019.

Methodology: Two hundred and nineteen patients were retrieved and died due to other reasons were excluded from the study while no any patient’s age and gender restrictions.

Results: There were 157 males and 62 females. Sixty six patients of asphyxial belonged to age 39-48 years. Among 74 patients of suffocation, 51 patients were males and 23 were females. There are 5 reported reasons of asphyxial deaths. Out of 45 hanging patients, 5 patients belonged to 18-28 years, 8 patients belonged to 29-38 years, 9 patients belonged to 39-48 years, 6 patients belong to 49-58 years and 15 patients belonged to ≥59 59 years. Conclusion: Male is the most vulnerable victim of the violent asphyxial deaths. The major contribution in the suicidal deaths is dominant by the hanging and strangulations. The manner of deaths indicates the frustrations and carelessness of the majority of the population. The social awareness and hopefulness contributed by the awareness sessions and education on Individual levels is encouraged for such cases. Keywords: Asphyxial, Post-mortem, Medicolegal causes