Context: Medicolegal autopsies are not only indispensable to identify the cause of  death; they are of vital importance in discovering various interesting and rare lesions/  diseases which were unnoticed or undiagnosed during the person’s life. Whether these
incidental lesions are the cause of death or not, they are of academic and research  importance. Hence this study was aimed to evaluate the various histopathological  findings in medico-legal autopsies and to highlight the rare incidental lesions.  method: This was a prospective cross-sectional study conducted on medico-legal  autopsy specimens over duration of five years, between August 2018 August 2023, at  Ramaiah Medical College Hospital, Bangalore. The viscera of each autopsy case were  evaluated grossly and microscopically to identify the various histopathological findings. results: A total of 554 histopathological lesions were identified in 549 cases, majority of which were found in cardiovascular system (47.6%), followed by pulmonary (31.3%),  hepatic (12.6%), renal (6.3%), central nervous (4.3%), splenic (3.8%), pancreatic (3.5%)  and female genital (0.5%) systems. The commonest lesion detected was atherosclerosis  (26%) followed by myocardial infarction (11.9%) and pulmonary edema (9.6%) Rare  incidental findings were observed in 5.8% of cases and incidental neoplasia was detected  in 1.6% of cases.  ConClusion: Varied spectrum of incidental lesions, which are not recognised during  the person’s life, are discovered at autopsy. Some of these lesions are preventable; some  warrant screening of close relatives and some, had they been detected before death,  would have changed therapeutic management. These incidental findings are important  for academic purpose, evaluating disease trends and introducing interventions.