Over the study period (January 1990-February 2002), 17 deaths were determined to be caused by the intentional ingestion of cyanide. Three important findings related to the autopsy results in cyanide deaths, potential risk factors associated with cyanide ingestions, and the toxicological analyses. Since not all laboratories routinely test all decedents for cyanide, the paucity of autopsy findings may allow cyanide deaths to be missed; therefore, it is important not to rely solely on the autopsy findings. Recognition of certain factors should raise the pathologist's suspicion of a possible death by ingestion of cyanide. Certain occupations and nationalities should raise suspicion that warrants testing for cyanide. These occupations include those that have contact with cyanide. The use of cyanide to commit suicide by people who have easy access to it is predictable and expected. These occupations include chemists; jewelers; and those involved in pest control, mineral refining, photography, electroplating, dyeing, printing, and salmon poaching. In certain cases, the occupation of the spouse of the decedent may be more important than the decedent's. Knowledge of the lethality of cyanide due to local events and/or other cultural aspects may explain the nationality association of these deaths. Guyana, for example, has had a number of well-publicized tragedies that have involved cyanide. The postmortem interpretation of cyanide concentrations has pitfalls due to reports of both postmortem degradation and the production of cyanide. Administration of the cyanide antidote kit in an attempt to save a person suspected of having ingested cyanide does not directly interfere with the toxicological analysis; however, it can explain the low concentration, since there is less cyanide available in the blood. 1 table and 23 references