This retrospective study examines pathologic findings in 593 captive cephalopods (340 octopuses, 130 cuttlefish, 33 squid, and 90 nautiluses; 22 species in total) submitted to International Zoo Veterinary Group Pathology between May 2003 and August 2022. Common octopus, European common cuttlefish, hummingbird bobtail squid, and chambered nautilus were the most numerous species from the included orders of Octopoda, Sepiida, Sepiolida, and Nautilida, respectively. Commonly identified conditions included coccidiosis and renal dicyemid mesozoan infection in octopuses, amebiasis in squid, bacterial infections in cuttlefish, and idiopathic multisystemic inflammatory disease in nautiluses. Coccidiosis was most frequent in common octopuses, giant Pacific octopuses, and California 2-spot octopuses (present in 68.4%, 46.3%, and 23.8% of these species, respectively) and was the attributed cause of death in 32.3%, 36.0%, and 60.0% of such cases, respectively. Ulcerative dermatitis (UD) was common, affecting squid, cuttlefish, and octopuses, while many nautiluses exhibited black shell disease and/or UD. Notable differences in the prevalence of UD were detected between laboratory and aquaria-housed decapodiforms; 52.2% for laboratory squid versus 20.0% in aquaria; 51.3% in laboratory cuttlefish versus 11.0% in aquaria. All octopuses and nautiluses in the study were derived from aquaria. Semelparity-associated death in Coleoidea species was identified in 22.4% of octopuses, 11.5% of cuttlefish, and 6.1% of squid. This report aims to provide an overview and reassessment of species-specific disease patterns under aquarium and laboratory management as a starting point for future developments in husbandry and disease investigation.