Objective : To evaluate coronary artery atherosclerosis in autopsy cases by morphologic  analysis.and to grade atherosclerosis as per American Heart Association.

Methods :  The present study comprised of 80 consecutive medicolegal autopsy cases received in the Department of Pathology, Solapur for histopathological examination for a period of six months. Autolysed specimens and cases where heart was not received were excluded. Representative bits were given from all heart specimens and were processed as per standard protocol. Microscopic examination of cross section of all coronaries was done for morphological grading of atherosclerosis as per the  American Heart Association criteria.

Results : Females (53.75%) outnumbered males and eccentric (67.81%) type of lesion was more common than concentric. Left main coronary was the predominant vessel involved. All cases with grade 6 lesion were associated with myocardial infarction.

Conclusion : Higher grades of atherosclerosis are inevitably associated with myocardial infarction.