In one case, a 47-year-old White man with a clinical diagnosis of paranoid schizophrenia with suicidal ideation was found dead by his mother in their basement. Prior to calling for help, his mother removed duct tape from his face. It had been cut into strips and applied in layers over the nose and mouth like a mask. The deceased's hands were loosely tied behind his back with thin rope that had two slip knots. Several suicide notes were found at the scene. An area of blanching of the face extended from the nasi to the chin, including the nareas and mouth. There was an associated, sticky gray material consistent with duct tape adhesive. The only gross pathologic finding at autopsy was cardiac hypertrophy. Histologic evaluation was not performed. There were no petechiae, and his blood contained therapeutic concentrations of diphenhydramine, olanzapine, and lorazepam. His death was attributed to asphyxia caused by occlusion of his nose and mouth by duct tape. In the second case, a 52-year-old White man was found dead by a hotel maid in his room. His head and face had been tightly wrapped with duct tape. There was no other binding. Upon removal of the tape at autopsy, skin blanching was observed in the area covered. There were no petechiae of the face or eyes. There was marked coronary artery stenosis and cardiac hypertrophy. A family member reported that the deceased had a gambling problem and was depressed. Death was attributed to asphyxia caused by nose and mouth occlusion with duct tape. 4 figures and 8 references