Backgrounds: Of all regional injuries, those of the head and neck are the most common and most important in forensic practice. The head is the target of choice in the great majority of assaults involving blunt trauma. When the victim is pushed or knocked to the ground, he often strikes his head.  The brain and its coverings are vulnerable to degrees of blunt trauma that would rarely be lethal if applied to other body areas. Objective: Study aimed to find out incidence and medico legal aspects of fatal blunt head injury to identify characters and magnitude of the problem to design a plan for better control of the problem. Subjects and method: Study was carried out retrospectively through collecting data from post-mortem report of all fatal blunt head injuries cases autopsied in Zeinhom mortuary during 2014.  The variables considered were age and gender of victim, cause and manner of death, type of weapon, types of skull fractures, and seasonal variation. Results: The studied group represented 129 cases out of total 2,128 cases that had been examined in Zeinhom mortuary during 2014.  The highest incidence of head injury was seen in victims of 3^rd and 4^th decades (79 victims; 60%). The majority were males (99; 76%). Ninety three cases (72%) were victims of homicide, while suicidal cases were 16 (12.4%), and accidental fatal head trauma victims were 20 (15.5%). Conclusion: Blunt trauma to the head is still a relevant challenge for the forensic pathologist who must obtain a complete and accurate history of the crime (including details regarding the crime scene), interpret patterns of injury and other findings at autopsy, and correlate all of the findings to make an accurate ruling of the cause and manner of death.