Medical examiner's system has been authorized by the act of Autopsy and preservation of corpses and the government ordinance for medical examiner's system since 1949 in Japan, and introduced only in five large cities (Tokyo metropolis, Osaka, Kobe, Yokohama, Nagoya). Recently in Ibaraki Prefecture, new forensic medical service system (Tsukuba Medical Examiner's office) was instituted. This new system is not authorized by the government ordinance, but authorized by the regional ordinance of Ibaraki prefectural governor, therefore this system is enforce only in Ibaraki prefecture. In our new system, medical examiner does not have discretionary power to order an autopsy, and family have a right to reject it, therefore an autopsy rate is very low (about 2%). One hundred and forty four autopsies have been conducted under this system. Ninety four of 144 autopsy cases (67%) were dead from sickness or natural death, in remaining 50 cases manner of death was accidental, suicidal or undetermined. The medical examiner does not conduct autopsies for criminal investigation or homicide cases in Ibaraki prefecture. These autopsies are conducted at the department of legal medicine, University of Tsukuba.