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By definition, autoerotic deaths are accidental. Thus, it is essential to exclude suicide or homicide. An atypical case of autoerotic asphyxia is presented, in which the victim showed a ligature mark produced by a soft belt with maximum pressure on the posterior aspect of the neck and the point of suspension located anteriorly. A detailed scene investigation and the autopsy findings helped determine the manner of death. Determining the manner of death in AADs can be challenging and has a significant legal, social, and economic impact. A multidisciplinary approach is required to reach the correct conclusion. We present a case of AAD with atypical findings.<\/jats:p>","DOI":"10.1177\/00258172221086110","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T03:22:46Z","timestamp":1663212166000},"page":"189-194","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["The shame of truth \u2013 death due to accidental autoerotic asphyxia"],"prefix":"10.1177","volume":"90","author":[{"given":"Biliana","family":"Mileva","sequence":"first","affiliation":[{"name":"Department of Forensic Medicine and Deontology, Medical University of Sofia, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Metodi","family":"Goshev","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Deontology, Medical University of Sofia, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandar","family":"Alexandrov","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Deontology, Medical University of Sofia, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Gitto","sequence":"additional","affiliation":[{"name":"Department of Pathology, State University of New York, Syracuse, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,9,15]]},"reference":[{"key":"bibr1-00258172221086110","doi-asserted-by":"publisher","DOI":"10.1007\/s12024-016-9826-5"},{"key":"bibr2-00258172221086110","doi-asserted-by":"publisher","DOI":"10.1007\/s12024-012-9319-0"},{"key":"bibr3-00258172221086110","first-page":"258","volume":"26","author":"Focardi M","year":"2018","journal-title":"Rom J Leg Med"},{"key":"bibr4-00258172221086110","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2020.110340"},{"key":"bibr5-00258172221086110","doi-asserted-by":"publisher","DOI":"10.1111\/j.1556-4029.2005.00032.x"},{"key":"bibr6-00258172221086110","doi-asserted-by":"publisher","DOI":"10.1007\/s00194-015-0072-z"},{"key":"bibr7-00258172221086110","doi-asserted-by":"publisher","DOI":"10.1016\/j.legalmed.2019.04.006"},{"key":"bibr8-00258172221086110","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2010.05.021"},{"key":"bibr9-00258172221086110","volume-title":"Autoerotic Asphyxiation. 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