Dissection of the vertebral artery represents a significant potential cause of strokes among young and middle-aged people. We present a case of dissection of the vertebral artery observed at the forensic autopsy of a professional basketball player who was suddenly taken ill during a practice game and died seven days after the event. A medico-legal autopsy was performed in order to establish an essential causal relationship between arterial dissection and basketball activity. No preceding trauma possibly contributing to the dissection was discovered. The histology of the arterial wall did not show specific alterations in the adventitia, the muscular layer, or the intima. In addition, the toxicological examination excluded any effects of drugs of abuse. We describe macroscopic and microscopic findings in the autopsy, and discuss possible mechanisms of the arterial rupture as well as the autopsy procedure in similar cases.