All autopsy reports from 1990-1994 inclusive of the Department of Pathology, University of Hong Kong and the Wales Institute of Forensic Medicine were examined and cases of death due to massive pulmonary embolism were noted. The incidence of this condition was calculated and found to be insignificantly lower in the Hong Kong series than the Welsh series by statistical analysis, both in the crude incidence in all autopsies and when correcting for different case mixes in the two locations. The majority of cases in both locations were in the over-60 age group. The study helps refute the longstanding belief among Hong Kong physicians that fatal massive pulmonary embolism is rare in Hong Kong (with approximately 98% Chinese population) in comparison with a predominantly Caucasian population.