Background The cause of death in any injury can only be determined with reasonable accuracy after a post-mortem. Evaluation of post-mortem results give us an understanding of the injury patterns that could lead to death.

Method We used one year data of a public post-mortem facility (mortuary) in Delhi, India. The data included all unnatural deaths whose post-mortem were conducted by a single forensic pathologist. The mortuary is close to an at-grade railway crossing with squatter settlement on either side. In India, ordinarily, post-mortems are done only in medico-legal cases, where deaths have occurred from injury, poisoning, suicide, or homicide. All homicide cases were excluded from the analysis. We assessed the region injured and the nature of injury for 140 cases.

Results There were 11 suicide cases with an average age of 26 years, 23 road traffic crashes, and 33 cases of pedestrians hit by trains on railway tracks. Visceral toxic investigation details were not available for any of the cases. Most deaths due to traffic crashes were severe head injuries with few truncal and abdominal injuries.

Conclusion Railways are considered a safe mode of transport and pedestrian deaths at railway tracks are not treated as rail related in India, leading to misclassification of such deaths. A large proportion of road traffic deaths were hit-and-run, however, injury patterns can be used to infer the striking mode of transport.