Background: Incidence of sudden cardiac death (SCD) is on the rise and a large spectrum of cardiac diseases, both congenital as well as acquired may be responsible for this. Presence of coronary vessels atherosclerosis is the most important cause of SCD in adults. In many such cases, the patient may not have any symptoms, which is discovered on post–mortem examination of the coronary vessels. Aims and Objectives: The aims and objective of this post mortem study was to analyse the gross and histopathological changes in coronary arteries in cases of SCD. Material and method: 34 cases of SCD were taken up for this retrospective study, during last three and a half years. The demographic data, gross post–mortem findings and histopathological data in relation to coronary vessels was retrieved and analysed. Observations and Results: There were 34 cases of SCD accounting for 8.33% of the total 408 post–mortem conducted during the period of study. Histopathologically, triple vessel disease was present in 67.6% cases and two vessel disease in 20.6% cases. Besides, there were 11.7% cases with single vessel disease. The left anterior descending artery(LAD), left coronary artery(LCA) and right coronary artery(RCA) showed more than 60% blockage in 64.7%, 44.1% and 41.2% cases respectively. Conclusion: The study highlights that triple vessel disease is one of the most important contributing factor that may lead to SCD. To assess the degree of blockage in coronary vessels, histopathology is the most important tool.