Forty-one instances of active tuberculosis first identified after death by a coroner's autopsy are reported. These constituted 0.3 per cent of the coroner's postmortem examinations and 31 per cent of all deaths from tuberculosis in Birmingham during the five years 1977-81. Many of the deceased in this series had been attended by a general practitioner shortly before death without the true nature of the disease being recognized. The value of a coroner's autopsy in establishing the actual cause of death is emphasized, especially when death might have been prevented by treatment as in many cases of tuberculosis.