Background: Autopsy is examination of a body post-mortem, with a view to determining the cause of death. Performing an autopsy has benefits for many parties: the family of the deceased, the clinician and hospital, and society at large. Materials and methods: The materials of the study were medico-legal autopsies (n=458) carried out by the Department of Forensic Medicine and Toxicology, BP Koirala Institute of Health Sciences between 15th July 2008 and 14th July 2009 (one fiscal year in Nepal). Autopsy reports were reviewed and interpreted in terms of the cause and manner of death, and demographic parameters. Results: The maximum number of reported cases was in the 21-30 years age group. The sex ratio of cases was 1.6:1 (M:F). The majority of deceased were from rural areas (60%), followed by urban areas (40%). There was no appreciable variation in the numbers of autopsies with respect to month of the year, or day of the week. Most deaths were either accidental (48.25%) or suicidal (40.83%). Homicide and natural causes accounted for 9.18% and 1.74% of deaths, respectively. Conclusion: The group most commonly affected was the young, productive age group, predominantly male. The majority of deaths were accidental or suicidal. Road traffic accident was the leading cause of accidental death. Poisoning was the leading method of suicide. Physical assault with blunt object was the most common cause of homicidal death.