In order to assess the level of agreement between clinical and autopsy diagnoses in the medical wards of a city and teaching hospital, we studied 94 consecutive patients autopsied during a 12 months' period. The rate of autopsy in this study was 59%. The main diagnosis was confirmed at autopsy in 80% of the cases, more precisely defined in 11% and discovered in 9%. Among 124 secondary diagnoses, 34% were diagnosed by the pathologist. The retrospective analysis of the cases in which there was disagreement between clinical and autopsy diagnosis showed that in 8 of them (8.5% of all patients), a clinical impact on survival was possible. However, all of these patients were over 80 and had multiple and/or terminal diseases. Thus, the real impact of these diagnostic errors is debatable.