Positional asphyxia may be defined as fatal ventilatory and circulatory failure caused by the fixation of the body in an abnormal position, which mechanically interferes with ventilation and venous return. This report describes a 30-yearold male who was found in a head-down position on a staircase. A thorough history and crime scene analysis unveiled that the deceased had fallen down the stairs and subsequently became unconscious. Autopsy revealed classical signs of asphyxia, and the injuries found were corroborated with crime scene evidence. The findings of the case were discussed by assessing Bell’s criteria for positional asphyxia. Improvisations of Bell’s criteria were suggested based on the case findings. Such cases present to forensic pathologists as sudden death, where crime scene examination, detailed history, and meticulous autopsy reveal evidence on the cause and manner of death.