The victim was found on a sand stack not far from his home in a large pool of blood. The external examination revealed a flat ulcer on the internal surface of the right shank. At dissection, the lesion contained a perforation that was continuous with superficial veins arising from a varicosed saphenous vein. It was apparent that the man had attempted to control the massive bleeding with a makeshift tourniquet on the leg above the bleeding, under the assumption of arterial bleeding rather than a rupture of a vein. This not only did not stop the bleeding, but exacerbated it. Death was caused by a hypovolemic shock because of external hemorrhage from a varicose vein. Severe or even fatal bleeding from a ruptured varicose vein is a rare phenomenon in clinical and forensic practice. Only a few cases of fatal bleeding due to ruptured peripheral varicosities have been described worldwide. In cases of fatal venous bleeding from varicose veins, failure to provide first aid may be linked to the lack of attention to small, continuous, and painless venous bleeding. This case is a lesson to doctors that they should discuss basic first-aid techniques for controlling bleeding with all patients who have varicose veins; this man's death could have been prevented by correct basic first-aid techniques. 4 figures and 10 references