The text provides overviews of sexual arousal, autoerotic behavior, erotic risk-taking, and the public visibility of autoerotic asphyxia. The historical development of knowledge about asphyxiation for sexual purposes is traced through a chronological presentation that shows the necessity for a multidisciplinary approach to this phenomenon. The nature of the study sample is described, and the characteristics and limitations of the sample are noted. A review of the pathophysiology of asphyxiation describes asphyxial autoerotic fatalities, the most frequently recognized form of autoerotic death. One chapter examines the relationship between autoerotic asphyxia, sexual orientation, psychosexual disorders, and other mental disorders. Particular attention is devoted to the evidence linking autoerotic asphyxia with sexual bondage behavior, sexual masochism, sexual sadism, fetishism, and transvestism. Next, the text considers autoerotic fatalities that did not result directly from the use of asphyxia to improve sexual arousal. These atypical autoerotic fatalities include those in which the cause of death was electrocution, chemicals other than anesthetics, natural disease, and other causes. A chapter on the investigation of autoerotic fatalities emphasizes the importance of thorough death-scene investigation. Equivocal cases -- in which another person may have been present or in which the manner of death remains elusive even after investigation -- are considered, and the process of behavioral analysis and reconstruction is described. The final chapter reprints cases and provides commentary on judicial decisions regarding death benefits. Chapter notes, an index, and about 180 references are provided. (Author summary modified)