The majority of adolescent deaths are sudden and unexpected; of these, the great majority result from violence. These violent deaths largely accounted for the 25% increase in total adolescent mortality during the 1960s. Yet, sudden death in adolescence is not a distinct entity and receives little study from either pediatricians or pathologists. Some cases of sudden death in adolescence are puzzling and difficult to classify. The pathologist must in each case obtain a detailed history, usually perform a complete autopsy, and obtain consultation when necessary. Only then will each case be adequately studied, and related medical questions and other problems be properly resolved.