A one year prospective study was carried out to compare clinical diagnosis antemortem with autopsy diagnosis post-mortem in all patients coming to autopsy. In the study period a total of 612 deaths occurred in the hospital out of which 179 came to autopsy representing an autopsy ratio of 29%. Of the 179 cases, 100 (56%) were cases referred to the coroner. A total of 143 cases were analyzed and the concordance rate between clinical and autopsy diagnosis was found to be 54%. We find the autopsy ratio abysmally low and recommend that all effort be made to increase it to 75% and that autopsy audit be officially adopted as a means of quality control in hospitals. We also believe that all concerned should work towards improving our clinical diagnostic ability in order to attain and maintain a concordance rate well above 90%.