Background and aims: Women’s unnatural deaths, which are frequently caused by homicides, suicides, accidents, and socio-economic reasons such as dowry violence and domestic abuse, are a major public health and forensic concern. Autopsies are crucial for ascertaining the cause of death and discovering foul play. However, the experiences of women in these settings are frequently underreported. The study will examine the medico-legal profile of unnatural female deaths reported at a tertiary healthcare facility. Methods: This retrospective analysis examined years of post-mortem records (2019-2023) of unnatural female fatalities, extracting socio-demographics, causes, ways, and circumstances from autopsy and police reports to identify patterns and contributing factors. Results: This retrospective analysis examined 434 unnatural female fatalities (January 1, 2019–December 31, 2023) from 5,791 autopsies (female 1,619). Most were 21-30 years old (32.95%), Hindu (81.80%), middle-school educated (45.16%), housewives (69.12%), and married (72.58%; 78.86% over 7 years). Accidents 52.30%, suicides 28.11%, and homicides 19.59%. Accidents: RTAs 34.8%, burns 28.6%, and 82.28% pillion riders. 71.3% of suicides involved hanging. Homicides: blunt trauma 6.69%, husbands 22.22%. Incidents between 12 and 8 pm: 61.98%; deaths: 50.23% at presentation overall. Conclusion: Unnatural female deaths primarily afflict young married housewives, who are killed by road traffic (particularly pillion riders), suicide by hanging, and homicides related to marital disputes/domestic violence, which husbands frequently commit. Peaks in the afternoon and evening, as well as a significant number of brought-dead instances, underscore the need for improved traffic safety, prevention of domestic violence, mental-health support, and speedier emergency response. 

Keywords: unnatural female fatalities; mode of death; medico-legal autopsy.