At the Institute of Forensic Medicine, University Innsbruck, 78 cases of fatal accidents and of sudden death were examined which occurred during alpine skiing between 1987 und 1990. An increase of fatal accidents during skiing was observed in the past few years. This fact is related to the rising utilization of summer skiing areas. In about three quarters of the cases death as consequence of an accident was observed. One quarter died a sudden death. In this group myocardial infarction is dominant, which is an indication of an enhanced load of the cardiovascular system during skiing in higher altitudes. In the group with fatal accidents cranio-cerebral traumas including medulla injuries are dominant.