Strangulation and hanging are defined as mechanical asphyxias caused by external compression of the throat with a string. In case of strangulation, the interfering force comes from the outside, unlike hanging, when the force is driven by the body itself. The limit between the 2 mechanisms is sensitive, and the doctor’s experience and vigilance are extremely important in solving these cases. Forensic case: 12th February, 2015, the coroner on duty is called by policemen to examine a male body, age 14, found dead in his uncle’s house, hanging by a cherry tree. At first sight, it seemed a regular case of complete, typically hanging, but at the autopsy, the coroner discovered two compression marks, one in the third superior of the cervix, and the second one, in the medium third. During the investigation, it turned out that the victim and his uncle had been involved in a sexual relationship and the uncle decided to murder his nephew by strangulation, in order to hide their inappropriate relationship. Being an engineer, afterwards he thought to dissimulate the strangulation by hanging, without taking into consideration the different medico-legal aspects of the two.