Objective To investigate the pathological features and significance of m yocardial contraction band necrosis in sudden cardiac death. Methods Using HE and PTA Hstaining, the distribution sites and pathological features of m yocardial contraction band necrosis were observed. The data were analyzed accord-ing to the extent of necrosis. Results The locations, pathological features and the extent of necrosis were sim ilar in different sudden death cases. The locations were related with sites of m yocardial dam age. The papillary m uscles of left ventricular were m ost occurred, followed by the anterior wall of left ventricular. In the sudden death cases caused by stress cardiom yopathy, the extent of m yocardial contraction band necrosis was lighter than the others. Most cases were predom inantly level 1, the others were level 2. Conclusion Used as the diagnosis basis of acute m yocardial ischem ia, the m yocardial contraction band necrosis has im portant significance to determ ination of death.