Sudden infant death syndrome (SIDS), also known as “cot death” is one of the most serious, unexplained tregedies of our times. The term “SIDS” is used when a sleeping infant, under the age of one year, who has apparently been healthy, is found unexpectedly dead, and forensic evaluation that consists of scene investigation, forensic autopsy and examination of the medical records of the child, is unable to discern a cause of death. Multiple sleep-related mechanisms have been proposed to cause SIDS. These mechanisms include suffocation/asphyxiation in the face-down sleep position, central and/or obstructive sleep apnea, impaired-state-dependent responses to hypoxia and/ or hypercarbia, inadequate autoresuscitation, defective autonomic regulation of blood pressure or thermal responses, and abnormal arousal to life-threatening challenges during sleep. It has been a somewhat controversial term that on one hand has been criticized for not being a proper diagnosis with pathognomonic features, contrasting on the other hand with situations where it has been uncritically and inconsistently applied to all manner of infant deaths. It has been argued that SIDS constitutes a disease with a single cause, an argument which is at odds with those who feel that it is instead a syndrome with common features, and probable heterogeneous and additive risk factors. For this reason it has been called a “diagnosis without a disease”. Despite the shortcomings of forensic medicine, the SIDS story over the past several decades has been one of the great successes in infant healthcare.