Objective: To determine the frequency, cause and manner of death, factors responsible, & to draw the attention towards the implementation of safety measures & building laws, for minimizing the incidences of fall from height. The autopsies were carried out in the three major hospitals i: e civil hospital, Jinnah post graduate medical center & Abbasi shaheed hospitals of Karachi. Study Design: Autopsy - based descriptive cross-sectional study. Place: Mortuaries at Civil hospital, Jinnah Postgraduate Medical Center and Abbasi-Shaheed Hospital of Karachi. Duration of study: The duration of study is based on five years, from January 1, 2007 to December 31, 2011. Materials & Methods: Data of 144 autopsies, due to fall was collected during the autopsies carried out in, three major Medico legal centers, i.e. Jinnah Postgraduate Medical Center, Civil Hospital and Abbasi Shaheed Hospital,during the study period. The findings with reference to age, gender, cause and manner of death, year wise distribution of cases and body parts sustaining injuries were recorded in the proforma. The police inquest, the crime scene reports were also examined to verify/confirm the facts of the cases. Results: Incidence rate of deaths due to fall was 1.29%. Male predominance, with 93.75% in comparison to 6.25% of females. Highest number of fall related deaths occurred in 2007 and more or less similar trend was observed during 2008, 2009 and 2011 with a decline. Two third of the studied cases belong to age group from 15-45 years. The accidental falls were the most common manner of death and head/skull was the leading part of the body, sustaining injuries either alone or combined with other parts of the body. Conclusion: Fatalities due to falls were substantially accidental, while working on heights, without safety & preventive measures in Karachi, predominantly involving males and young of 15-45 years of age group. The Head was the leading part of the body involved in majority of cases, indicating the necessity of the implementation of the building laws protecting, the rights of poor labor, working on heights & minimizing the fatal injuries.