This is a prospective and retrospective study about the deaths due to suicide by hanging in a small town in Brazil. All bodies underwent autopsy examination. The author performed the prospective part of the study, while the retrospective data consists of postmortem examinations performed by other forensic team of the Forensic Medicine Institute of São Paulo. In addition to demographic data on suicide deaths in Brazil, the study compares the internal cervical lesions found in autopsies performed by the author and those found by other medical staff.The author is Professor of Forensic Medicine in different medical schools in Brazil, and has 25 years experience as a medical examiner. He is a leading specialist in death by asphyxiation.