All rights reserved. Introduction iyadh is the capital city of the Kingdom of Saudi Arabia and includes 20 governorates with a total population of 6,167,262 people (24% of the Kingdom population). In this region, all medico-legal autopsies are performed by staffs of the Forensic Medicine Centre in Riyadh. The term asphyxia is defined as "a condition caused by interference with respiration or lack of oxygen in respired air, the result of which organs and tissues are deprived of oxygen (together with a failure to eliminate carbon dioxide), causing unconsciousness or death "(Reddy, 2009).Asphyxial deaths are common in forensic practice, and it is important to determine the manner of death in these cases. Autopsy plays a major role in such deaths, as do scene investigation and the analysis of samples (Azmak, 2006). The classification of the different forms of asphyxia is far from uniform, varying from one textbook to another and from one paper to the next (Sauvageau and Boghossian, 2010). Asphyxial deaths are often classified into the following methods: strangulation (hanging, manual, ligature), suffocation (environmental or entrapment, smothering, choking, mechanical [positional, traumatic], suffocating gases), chemical asphyxia (carbon monoxide [CO], hydrogen cyanide, hydrogen sulphide), and drowning (DiMaio and DiMaio, 2001). Gaseous suffocation refers to cases in which a gas displaces oxygen from the environment, leading to a hypoxic air mixture, while in chemical asphyxia, inhalation of gaseous compounds prevents the utilization of oxygen at the cellular level (Dolinak, et al., 2005). Aim of the work This study aimed to evaluate asphyxial deaths in Riyadh, Kingdom of Saudi Arabia by the retrospective analysis of the autopsy results during two years' period (from January 1 st 2012 to 31 st December 2013). Subjects and Methods From a multinational population of more than 6 million people in Saudi Arabia, a total of 671 cases were referred to the Forensic Medicine Centre in Riyadh for autopsy over the two-year study period. Retrospective analysis of the autopsy records indicated that 172 cases (25.6%) of these deaths was attributed to asphyxia.