Backgrounds: When a body is discovered suspended, forensic pathologists are tasked with determining the manner of death, which may involve ruling out or confirming potential criminal involvement. While conclusions are straightforward in cases with classic findings, interpreting atypical findings presents a dilemma. This study aims to analyze autopsy findings in hanging-related deaths to gain insights into both typical and atypical presentations, thus highlighting the challenges in interpretation Methods: This retrospective descriptive study examines post-mortem records of individuals who died by hanging over a three-year period, as brought to a tertiary care hospital. The analysis focuses on the findings of death investigations, encompassing background information, scene details, and autopsy examinations. Results: A total of 112 records documenting deaths by suicidal hanging were reviewed, with 97 cases (86.6%) involving male individuals. The largest proportion of victims (37%) fell within the age range of 21 to 40 years. Complete suspension was identified in the majority of cases (79.5%), while coir rope emerged as the most common ligature material (25%). Sixty-nine cases exhibited a ligature mark forming an inverted 'V' shape. Classic signs were present in 47% of cases, with their occurrence significantly linked to partial suspension (p<0.001). Internal injuries, including fractures, were noted in 34% of cases, although their presence showed no significant association with the degree of suspension (p=0.11). Conclusion: Variations in hanging findings are common, often presenting in diverse combinations and occasionally deviating from established norms. Understanding these variations and exceptions is vital for reaching accurate conclusions in suspected hanging cases, thus mitigating the risk of erroneous opinions.