Introduction: Tramadol is a synthetic opioid used to control chronic pain and pain after surgery however, many cases of poisoning and dangerous side effects have been reported. In order to discover the causes of death in forensic medicine is usually examine tissue samples taken from the body, although the results of toxicology tests generally give us more information. But identifying the pathological effects of tramadol on the internal organs, especially the lungs can be very helpful. Methods: In this cross-sectional study, information on the history, the autopsy report and toxicology testing of patients who died due to acute poisoning tramadol were studied. In this study, all of the information already provided by the use of particular forms collected and then analyzed using computer software 16 spss. Findings: A total of 49 patients were examined in this study. 39 dead (79.5%) of men and 10 body (20.5%) were women-owned. Most common age groups in the study were 24 to 34 years old (41%), were reported. There were significant difference between Lung microscopic spread among different ages, sex, positive and negative toxicology tests stomach contents, urine, blood, tissue and vitreous. Most common pathological change was in lung edema and Atelectasis. Aspiration and pneumonia signs was seen only in patients over 40 years old. Conclusion: Tramadol poisoning among young people is increasing. In this study, the majority of patients had acute poisioning with tramadol, it can be concluded that the majority of changes in tissue obtained is as a result of acute tramadol, respectively incidence of atelectasis and edema and alveolar bleeding in the lung were most pathological findings.
