Background: The Hyoid bone is the most important part of internal examination at the autopsy table while performing autopsy in cases of Hanging and Ligature strangulation. Fracture of hyoid bone has been ascribed to many factors like manners of constriction, level of application of ligature material or force of constriction, long drop or short drop suspension, age and sex of victim etc. It is also very important to check whether it is ante mortem or postmortem in nature or just an artifact. Observing the importance given to hyoid bone fracture in hanging and ligature strangulation cases by many authors in past and present days, the present prospective study was performed on asphyxial deaths due to hanging and ligature strangulation. Objectives: To study the fracture of neck structures in hanging and ligature strangulation deaths. Study Design: Prospective study. Study Setting: This study was conducted at P.D.U. Medical College and Hospital, Rajkot during January 2008 to December 2008. Result: During that period out of 2159 cases, 90 cases of hanging and 7 cases of ligature strangulation were selected for the present study. Hyoid bone was fractured in 16 cases (17.78%) of hanging. In one case (1.11%) of hanging where thyroid cartilage was fractured. In two cases (28.56%) of ligature strangulation, thyroid cartilage was fractured. No fractures of the cricoid cartilage or cervical spine were demonstrated. Conclusion: Incidences and postmortem findings of fracture of neck structures in cases of hanging and ligature strangulation were almost same which was observed by the other recognized authors in the field.