Background: Firearm injuries are a common cause of death in cases typically investigated by medical examiners. Postmortem multislice computed tomography (PMCT) provides valuable information that enhances the autopsy examination. This study was conducted to compare PMCT and autopsy for the detection of injuries and causes of death in cases of fatal firearm injuries. Thirty cadavers were scanned with PMCT and then underwent autopsy. The results of the two techniques were compared regarding entry wounds, wound channels, detection of foreign bodies, organ and skeletal injuries, and causes of death to determine the concordance or discordance between the two techniques. Results: The results revealed excellent agreement between PMCT and autopsy for the detection of injuries and causes of death in cases of gunshot injury. Furthermore, PMCT revealed injuries such as pneumothorax and surgical emphysema that were found to be undetermined by autopsies where the special dissection technique was not part of our routine procedures. Conclusion: PMCT could be a valuable complementary tool for autopsies to determine and localize injuries and causes of death in cases of gunshot injury.