Sports-related sudden death is an unusual event. It causes a great social impact. The incidence has been heterogeneous, and coronary artery disease is the most frequent cause in subjects over 35 years-old. Cardiomyopathies and congenital coronary artery anomalies are more usual in younger people. The performing of a medicolegal autopsy is necessary in most cases. A detailed death scene investigation has to be performed, along with a full autopsy with toxicological and histopathological investigation. If the autopsy is negative, genetic studies are requested to rule out disease that may cause cardiac arrhythmias. Sudden deaths in custody, including those occurring in a restraint and containment context, have a special interest in Forensic Medicine, for the multifactorial causes as for the circumstances in which they occurred, as well the social media and medicolegal repercussions. This article presents a review, using a practical approach, for the forensic physician.