In recent decades several systematic investigations of deaths in police custody have been conducted with at times very different inclusion and exclusion criteria. The deceased were mostly men between the ages of 30 and 45 years. In European countries there is a clear predominance of nonnatural deaths. In cases that do not involve the use of force by police, intoxication is in the foreground. Deaths involving the use of force by the police, such as gunshot wounds and restraint measures, are more common outside Europe. The forensic medical assessment should include a post-mortem computed tomography (CT) scan and a comprehensive dissection of the soft tissue system in addition to the on-site external examination of the corpse. Furthermore, toxicological, chemical and histological examinations are required. Depending on the circumstances of the case, cardiopathological and neuropathological examinations as well as interdisciplinary consultations are recommended. For further clarification, the medical history, the possible determination of fitness for custody, the police custody record book and the currently valid custody regulations must be consulted. In future systematic studies a distinction should be made between deaths in police custody in the strict sense and deaths related to the use of force by the police. Repeated studies in the same regions can be helpful for testing the effectiveness of preventive measures. Another starting point is systematic error analysis in the context of scientific studies or recording in national databases. Furthermore, national and international standards should be developed for the assessment of the fitness for custody.