Objective: We investigated in 1006 autopsies of stillbirths the usefulness of autopsy even in the absence of risk factors and/or apparent anatomical/clinical causes which could explain the death. Method: From January 1990 to December 2010 (Institute of Pathology, Paolo Giaccone-Palermo) 2643 autopsies on dead uterine foetuses were performed. 1637 cases were abortions (<25 weeks), 1006 were stillbirths (≥25 weeks). In all cases the autopsy included a macroscopic and microscopic examination both of the foetus and the placenta. The final diagnosis of death was based on both the morphological and clinical data. Of the 1006 stillbirths, 715 cases were "risk factor pregnancies", 291 non. Results: The stillbirth mortality was classified as follows: -Sudden Intrauterine Unexplained Death (SIUD,"sine materia" and absence of risk factor autopsies),4 cases; -Explained Intrauterine Death ("cum materia" with or without risk factor autopsies),987 cases; -Borderline Intrauterine Death ("sine materia" and presence of risk factor autopsies),15 cases. Conclusion: In the absence of autopsy in 715/1006 cases it was possible to establish the cause of death based on the presence of risk factors. In the absence of risk factors the autopsy showed a certain anatomical cause in 287/1006, only in 4/1006 it was "sine materia".