The obligate anaerobic bacterium Clostridium tetani is the causative agent of generalized, localized, cephalic, and neonatal tetanus [1]. The most frequent and serious clinical manifestation is generalized tetanus, which causes trismus, lockjaw, tonic contractions, spasms, and autonomic nervous system dysfunction [2]. The annual rate of tetanus between 2006 is 2019 in Tokyo was 5.9 [3]. Knowledge of the clinical outcomes of tetanus is necessary because it can result in severe symptoms and death. Herein, we describe an 85-year-old woman with no remarkable history of trauma who died of tetanus and was analyzed at autopsy.