Autopsy can lead to the cause of death most accurately in both natural as well as unnatural deaths. Purpose: To determine the pattern of deaths seen on autopsy in a tertiary care hospital and to determine the cause of deaths and manners of deaths with special focus of homicidal cases, seen on autopsies in the past few years. Study Design: Retrospective study. Methodology: Patients (n=186) were enrolled in present study held at Forensic department, Sheikh Zaid Hospital, Lahore-Pakistan. Data of 186 autopsy cases of 5 years from 2016 to 2020 was entered and analyzed. All the forensic autopsies done at the forensic department, irrespective of the age and gender were included in the study. Statistical analysis: Data analyzed by SPSS 22.0v. Results: Most of the patients were of age group 20 to 30 years. Males were 67% while females were 20% in present study. Among these 186 cases of autopsy, manner of death was homicidal in 43% (n=80) autopsies, accidental in 10% (n=19) and suicidal deaths was in 1.6% (n=3) while in 34% (n=64) autopsy cases cause of death cannot be determined. Conclusion: This study concluded that the cause of death couldn’t be determined in around 1/3rd autopsies; showing that steps should be taken to improve performance of forensic departments. As young males are mostly involved in criminal acts, illegal activities should be controlled with education and law enforcement. Key Words: Autopsy, Audit, Manner of Death and Cause of Death.