Pituitary adenomas make up 10% of intracranial tumors, but because of their location, they may go undetected for long periods. In this article, we report the case of a 68-year-old white man found deceased in his residence, who died of acute pituitary tumor apoplexy. He was known to have severe symptoms including acute headache, vision loss, and altered behavior. When found, his home was in extreme disarray, mimicking a possible assault. At autopsy, the decedent had multiple superficial abrasions about the upper and lower extremities, as well as a 2.5 × 3-cm pituitary adenoma compressing the carotid arteries and optic nerves. Initial coroner and police investigators were strongly considering homicide with robbery as a motive, given the disarray present at the scene. This case highlights the importance of postmortem examination of the pituitary gland in all cases where neurological symptoms are reported prior to death.