Being rich in tribal communities, Jharkhand has a significant fraction of population with HbS trait. The disease has a variable presentation and most of the times the patients are asymptomatic for a long period of time.While, some patients gets crippled by repeated vaso–occlusive crisis, other have a mild symptoms.Keeping this in mind, autopsy surgeons rarely think of sickle cell disease as a cause of death in cases of death with no apparent cause, thereby making it an under–reported cause of  death even in areas with high  prevalence.

A case report of a male with post–mortem histopathological findings of sickle cell in the myocardial vessels is been presented here.