Attempts to increase masturbatory sensations by reducing the oxygen to the brain may be attempted through a noose or ligature around the neck or nitrous oxide injected into a bag over the head. Oxygen deprivation, danger, and fantasy combine to bring heightened sexual gratification to those who engage in such activities. Death from such an activity may result from failures of the victim's psychological mechanism, the self-rescue device, and the victim's judgment and ability to control a self-endangering fantasy scenario. Although most of the literature on autoeroticism focuses on the involvement of teenage boys and older men, females may also engage in the practice. These deaths are often mistaken as suicides or homicides because investigators are not familiar with the evidence associated with an autoerotic death. Some evidence that may indicate the victim's autoerotic intent includes victim nudity, evidence of masturbatory activity, the presence of sexually stimulating paraphernalia, the use of bondage, interconnecting restraints, evidence of fantasy, a suspension point within reach of the victim, and evidence of prior autoerotic activity. Case histories of autoerotic deaths are presented.