The present study is aiming at sharing our problems and experience with pediatric autopsy cases. The incidence of pediatric cases as part of total autopsy activity is estimated. Criteria such as coincidence between pediatricians' and final pathological diagnosis are considered. The research is retrospective and it is made for the period from 1985 to 2001. It includes review of 5663 autopsy files from which only pediatric cases were extracted, divided into separate age groups. Main disease, causes of death and complications are recorded for each separate age group. The first two age groups constitute the major part of pediatric mortality with the substantial participation of the neonate group--771 cases, followed by the second period (30 days-1 year)--563 cases. They show a similar rate of causes of death and hemorrhagic complications prevail either as isolated or in the context of DIC-syndrome. The vast majority of pediatric cases belong to neonatal period and the first year of life. A rapid decline in autopsy rates is observed concerning early school age (5-7) and the teenager group (7-11 yrs). In the era of a definite autopsy rate decline, Bulgarian pathologists meet with fewer pediatric cases.