Objectives: The current work aimed to study carbon monoxide (CO) related deaths in Alqurayyate during the period from 2004-2018. Methods: All medico-legally examined cases with carboxyhemoglobin [COHb] levels ≥ 10%, within the study years, were investigated. The demographic data, autopsy findings and toxicological laboratory results for the cases of interest were collected. Results: Among 461 autopsied cases, 52 cases [11.3%] show carboxy-hemoglobin (COHb) levels≥ 10%. Higher COHb levels were significantly more common among males, young and elderly and Saudi people [0.012, 0.009, and 0.3 respectively]. was the cause of death in 19 cases [4.1%] while CO poisoning was suggested as a contributing factor in another 33 [7.2%] deaths. The mode of deaths was mainly accidental [78.8%]. Houses were the most common place of death [63.5%] and most CO related deaths happened in the winter months [73.1%]. The most common suggested source for exposure to CO among carbon monoxide poisoning (COP) deaths were car exhaust [36.8%], followed by charcoal heaters [31.6%]. Regarding autopsy findings, the external appearance revealed cherry red hypostasis in only 26.9% of CO related cases. The most common findings were pulmonary edema, cerebral edema, and congested lungs [96.2,82.7, and 80.8 % respectively]. Conclusion: COP remains a common cause of death, inspite of the safety precautions. More public awareness programs about COP are recommended. Also, COHb levels should be routinely estimated in the autopsied cases, especially with suggestive history and death scene.