The goal of this presentation is to present to the forensic community a case of death due to a rare systemic syndrome: abdominal compartment syndrome (ACS). This case has been studied by means of autopsy and histological examinations. Abdominal compartment syndrome (ACS) is broadly defined as organ dysfunction derived from increase in intra-abdominal pressure. Prolonged, unrelieved increased intra-abdominal pressure at more than 20 mm Hg can produce pulmonary compromise, renal impairment, cardiac failure, shock and death. This presentation discusses the clinical-pathologic features, the postmortem findings and microscopic features of a fatal case due to ACS.