A retrospective study was carried out on 172 cases of asphyxial death autopsied at the Forensic Medicine Centre in Riyadh, Kingdom of Saudi Arabia during the period from January 2012 to December 2013. Of the 172 cases, 111 (64.5%) were male and 61 (35.5%) were female, with approximately 51% of the cases being male manual workers and 28.5% female housemaids; the most common age group was 21-30 years (52.3%). Saudi nationals comprised only a small proportion of cases (11.6%), the majority of deaths were amongst foreign workers. Suicide was the most common manner of death (87.8%) followed by accident (10.5%), and few homicides (1.7%). As expected, the most common cause of death was hanging (87.8%) followed by drowning (6.4%), ligature strangulation (3.5%) and chemical asphyxia, i.e., carbon monoxide poisoning (2.3%). Alcohol, amphetamine and cannabinoids were found in 7.6%, 2.3% and 1.7% of cases and carboxyhaemoglobin was found in 2.3%.