Intensive care unit has a high mortality rate where despite best of the efforts by the healthcare staff, some patients will not survive. Autopsy studies have shown that missed diagnosis is not an infrequent occurrence. However, the rates of hospital autopsies are variable. ‘Digital autopsy’ is a recent modality, which can reduce the need for open autopsies, besides providing useful information about the cause of death instantaneously. Resource constraints mean that it is not universally applicable at present. Apart from correct diagnosis, the ‘process of care’ is also vital to successful outcome. ‘Mortality review’ or audit of all deaths in intensive care should look at this aspect, which in turn will help identify areas for individual, team and system improvements