Objective Since the demise of advanced pulmonary tuberculosis in our community, fatal haemoptysis is unusual mostly seen after penetrating trauma including surgical procedures and advanced malignancy. Detection of the responsible vessel at autopsy can be technically difficult. Postmortem CT angiography (PMCTA) is routinely used at our institution to identify sites of bleeding. Material and methods 170 PMCTA procedures have been performed since 2010 utilizing a modified Bern technique including a solution of iodine-based radiographic contrast and PEG 200, infused via the femoral artery using a Dodge ® embalming pump and dual energy CT imaging. 10 cases of massive haemoptysis were identified. PMCTA images were reviewed and correlated with autopsy findings. Results Of the 10 cases, 4 were ultimately shown at autopsy to be due to advanced malignancy and 6 traumatic (5 of these iatrogenic). PMCTA was able to detect a bleeding point in 9 of 10 cases, being negative in a case of post CT-guided lung biopsy. In one case, the PMCTA detected a bleeding point in the trachea following oesophagogastrectomy for caustic ingestion. At autopsy the pathologist was unable to detect any specific bleeding vessel. Conclusion PMCTA as applied at our institution is useful for identifying bleeding points in massive haemoptysis. Intervention to the body is remote to the site of pathology (avoiding artefact) and the whole body vascular opacification allows assessment of all possible responsible vessels including sites not necessarily suspected prior to autopsy. Localizing disrupted vessels prior to autopsy allows the pathologist to focus their dissection.