INTRODUCTION: Atherosclerosis and its complications were previously thought to be rare in Africans. This trend is however changing with westernisation of our life style. Many studies on alteration of the integrity of blood vessels with age and sex are based on radiologic examinations. Regional differences in atherosclerotic lesions using multiple blood vessels are rarely studied hence the need for this autopsy study. AIM: This study will assess the patterns of atherosclerotic lesions in autopsy cases in University of Benin Teaching Hospital and also related findings to age, sex, heart size and premorbid state using multiple blood vessels. METHDOLOGY: This was a prospective study of all autopsy cases of individuals who were above 14 years, over a period of one year, from June 2012 to May 2013 in the University of Benin Teaching Hospital. Cerebral vessels, abdominal aorta and coronary arteries were examined and atherosclerosis thereof was graded according to American Heart Association classification.