During the Nagorno-Karabakh war, he visited various battlefronts. He was particularly elated about the Armenian victory at the Battle of Kalbajar. In the last months of his life, Karamanoukian toured around the world and visited friends and family in Syria, Armenia, France, and Lebanon. After returning to the United States, he fell gravely ill, and died in Fort Lee, New Jersey on 23 December 1996. In accordance to his will, his remains were transferred to Aleppo and Armenia. In Armenia, part of his remains were buried next to his brother Levon in Yerevan. In Aleppo, the rest of his remains were buried at a local Armenian church. His funeral was attended by many senior officials and dignitaries.