The fatal outcome of polytrauma is frequently linked with trauma-associated infections that generalize to systemic inflammation, and with multiple organ dysfunction syndrome as a cause of death. Likewise, end-stage internal affliction such as metastasizing tumor disease is characterized by this type of systemic failure. Postmortem angiography is predominantly the means of choice for adding value to autopsy findings when neoplasms cause disturbed blood flow and fatal hemorrhages. The source of fatal bleeding is of particular interest in post-surgery fatalities following tumor resections. Mass-occupying lesions sometimes appear to displace adjacent vasculature in postmortem CT angiography (PMCTA), but postmortem contrast enhancement rarely facilitates the detection of small and medium-sized tumors. PMCTA may be particularly helpful in cases of large-vessel vasculitis, paraneoplastic thrombosis, septic embolism, or spontaneous hemorrhage in patients with coagulation disorder. Multiple organ dysfunction syndrome facilitates a general enhancement of organ tissues (particularly in liver, spleen, and kidney parenchyma) owing to the distribution of oil-based agents for postmortem angiography, as in multiphase PMCTA. However, prolonged postmortem periods may result in a similar phenomenon.