Background: The role of autopsy is to find out the cause of death, time of death and identify diseases which could have attributed to the death. Autopsy may reveal many histopathological findings which may or may not have been diagnosed ante mortem. A retrospective study of medicolegal autopsies for a period of 2 years was done in a tertiary care centre in Kerala. Clinical findings and ante mortem clinical diagnosis, gross pathological findings and histopathological details were noted. The results were analyzed based on gross findings and histological examination. Histopathological findings which were diagnosed incidentally or co-existing pathology which may or may not have been the cause of death were specifically noted. All the data were analysed using the SPSS software version 17. Results: The present study was based on 212 male and 92 female autopsies. Coronary arterial disease, myocarditis, pneumonia and cirrhosis liver were the common findings. Some of the other pathological findings noted were tuberculosis, burns, pancreatitis, meningitis, encephalitis and cardiomyopathy. There were 6 cases which showed rare and incidental findings. Conclusion: The diagnosis of incidental findings which were not diagnosed ante mortem emphasise the relevance of histopathological analysis in all cases of autopsy .This can also help in epidemiological studies.