Abstract Objectives: To evaluate the inconsistency between clinical diagnosis of death and autopsy findings in adolescents with chronic diseases. Methods: A cross-sectional study including a sample of adolescents’ autopsies who died in a pediatric and adolescent tertiary hospital over 18 consecutive years. During this period, there were n = 2912 deaths, and n = 581/2912(20%) occurred in adolescents. Of these, n = 85/581(15%) underwent autopsies and were analyzed. Further results were divided into two groups: Goldman classes I or II (high disagreement between main clinical diagnosis of death and anatomopathological findings, n = 26) and Goldman classes III, IV or V (low or no disagreement between these two parameters, n = 59). Results: Median age at death (13.5 [10‒19] vs. 13 [10‒19] years, p = 0.495) and disease duration (22 [0‒164] vs. 20 [0‒200] months, p = 0.931), and frequencies for males (58% vs. 44%, p = 0.247) were similar between class I/II vs. class III/IV/V. The frequency of pneumonia (73% vs. 48%, p = 0.029), pulmonary abscess (12% vs. 0%, p = 0.026), as well as isolation of yeast (27% vs. 5%, p = 0.008), and virus (15% vs. 2%, p = 0.029) identified in the autopsy, were significantly higher in adolescents with Goldman class I/II compared to those with Goldman class III/IV/V. In contrast, cerebral edema was significantly lower in adolescents of the first group (4% vs. 25%, p = 0.018). Conclusion: This study showed that 30% of the adolescents with chronic diseases had major discrepancies between clinical diagnosis of death and autopsy findings. Pneumonia, pulmonary abscess, as well as isolation of yeast and virus were more frequently identified at autopsy findings in the groups with major discrepancies. Objectives Methods crosssectional cross sectional 1 years period 291 deaths 581/291220% 581291220 581/2912 20% 581 581/2912(20% 85/58115% 8558115 85/581 15% 85 15 85/581(15% analyzed high 26 III low parameters 59. 59 . 59) Results 13.5 135 5 (13. 10‒19 1019 10 19 [10‒19 vs 0.495 0495 0 495 22 (2 0‒164 0164 164 [0‒164 2 0‒200 0200 200 [0‒200 months 0.931, 0931 0.931 , 931 0.931) 58% 58 (58 44 44% 0.247 0247 247 IIIIVV III/IV/V 73% 73 (73 48 48% 0.029, 0029 0.029 029 12% 12 (12 0% 0.026, 0026 0.026 026 0.026) 27% 27 (27 5% 0.008, 0008 0.008 008 0.008) (15 2% contrast 4% 4 (4 25 25% 0.018. 0018 0.018 018 0.018) Conclusion 30 Pneumonia 29 291220 581/291220 58129122 5812912 581/291 581/2912(20 58115 85/58115 855811 85581 85/58 8 85/581(15 13. (13 10‒1 101 [10‒1 0.49 049 49 ( 0‒16 016 16 [0‒16 0‒20 020 [0‒20 093 0.93 93 (5 0.24 024 24 7 (7 002 0.02 02 (1 000 0.00 00 001 0.01 01 3 29122 581/29122 581291 581/29 581/2912(2 5811 85/5811 8558 85/5 85/581(1 10‒ [10‒ 0.4 04 0‒1 [0‒1 0‒2 [0‒2 09 0.9 9 0.2 0.0 58129 581/2 581/2912( 855 85/ 85/581( [10 0. 0‒ [0‒ 5812 581/ [1 [0 [