With the increasing forensic investigations using MDCT (multidetector computed tomography) and MPMCTA (multiphase postmortem CT angiography), questions have arisen concerning the applicability of these methods for investigating altered bodies. The degree of decomposition and other forms of alteration on radiologic images are reflected in the Radiological Alteration Index (RAI, see Chap. 5), which quantifies the presence of gas in the body using postmortem MDCT imaging. MPMCTA appears to be acceptable for use on putrefied bodies and provides good opacification of the vascular system and pertinent diagnostic value. Some additional artefacts have been observed in these particular cases; however, on bodies with major traumatic alterations, including major vascular lesions at the thoracic or abdominal level, a perfusion deficiency in the upper levels has been observed, hindering vascular diagnosis in these regions. Therefore, a switch to another technical approach, such as selective postmortem CT angiography (PMCTA), should be considered for obtaining all pertinent information for the investigation of the cause of death.