Despite the recognized advantages of a complete postmortem examination, autopsy rates continued to decline in recent decades. This study compares postmortem needle sampling to the complete, conventional autopsy to determine whether needle sampling is a viable alternative when consent for a complete autopsy is denied. A prospective study where postmortem percutaneous biopsies were obtained from the heart, the lungs, the liver, the kidney, and any other clinically relevant tissue or body fluid before the complete autopsy in 20 consecutive patients is presented. Cultures of the lungs, the spleen, and any other suspicious body fluid were also obtained. Liver and heart were recovered from all 20 of the patients, lung from 18 (90%), and kidney from 16 cases (80%). The cause of death was confirmed in 67% of the patients. Needle sampling correlated with the complete autopsy in 87% of the additional major diagnoses and with equally pertinent negative results. Postmortem needle lung cultures correlated with the complete autopsy in 17 (85%) of 20 patients and 16 (80%) of 20 spleen cultures. Cultures of the brain (one patient), cerebrospinal fluid (two patients), peritoneum (two patients), and serum (one patient) correlated 100% when compared to the complete autopsy. A complete autopsy is the goal of every postmortem examination. Postmortem "biopsies" can be an alternative option in certain situations and may be more acceptable to relatives of the deceased when consent for a complete autopsy is declined.