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Dying in a head-down position is a not so common occurrence, and the cause of death may not be immediately clear by the results of the autopsy. The authors describe a case of a six-months-old baby, previously healthy and asymptomatic, found in a head-down position, stuck between the bed and the wall. Despite the efforts to revive the baby, he was declared dead at the arrival of the ambulance. After the autopsy was carried out it was deemed that the cause of death was a cardio-respiratory failure caused by upside-down position of the baby, bilateral interstitial pneumonia and the immobilization of the thorax. This case shows how important it is, for the forensic pathologists, to take into account both autoptical, histological, toxicological results and the report of the scene, especially in the absence of decisive findings.