We present a single case report illustrating the diagnostic role of multi-slice computed tomography (MSCT) in the investigation of suspicious child death where mechanical asphyxia is suspected. The case illustrates how radiological findings that may not be observable on conventional plain X-ray were identified by post-mortem MSCT. We illustrate how MSCT can illustrate the position of a foreign body within the upper airway of a neonate without the need for in situ dissection and how the combination of post-mortem MSCT with skeletal survey can provide enhanced diagnostic information in the investigation of not only whether the child was liveborn but also the consideration as to whether or not death has been caused by upper airway obstruction.