A death certificate was issued without a medicolegal autopsy in one third of all Swedish cases of unnatural death during 1991 through 1996. Out of 415 unnatural deaths in the northern part of Sweden, not subjected to a medicolegal autopsy but analyzed in this study, only 14% were reported to police authorities. Elderly, women and patients dying after a longer period of hospital care were more often not reported to the police. It is recommended that forensic pathologists be consulted in order to achieve better management of unnatural deaths.