Hypothermic deaths are seen across the United States, but are more commonly seen in Alaska compared to the other states due to its northern latitude and variable climate. Vulnerable populations, such as the homeless and people with substance abuse are at increased risk. Our approach is to examine the scene circumstances, patient health factors, and autopsy findings to arrive at an accurate categorization of cause and manner of death in these cases. Literature on hypothermia is reviewed and various features of hypothermia including scene findings and pathophysiological findings of the victims are discussed. Various Alaskan cases demonstrating common features seen in hypothermia death are discussed. Photographic demonstration of the typical findings in the cases are shown and described. Methods of diagnosis and prevention are given at the conclusion of the article.