South Africa is burdened by both an exceptionally high crude death rate and a very high non-natural death rate. Efficient death investigation may greatly aid in identifying and addressing public health issues, while also being a prerequisite for the administration of justice. To improve the quality and consistency of death investigation in a country or region, it will help to have an understanding of relevant historical developments as well as the current sociopolitical, legislative, and organizational perspectives which may shape and underpin the forensic medical and scientific investigation of death. This review aims to provide the reader with some insights in this regard.