The field of autopsy pathology is enjoying an unexpected renaissance as new and improved uses for postmortem examination are found in quality improvement, education, and research.  Increased interest in the autopsy is evident in the popular press as well as in national and international physician meetings.  This text provides an overview of topics the authors consider crucial to competent and effective autopsy practice in the 21st century.  Each chapter combines relevant theoretical background with current and practical experience-based guidance so that pathologists and clinicians can better utilize the autopsy to provide optimal value to families, patients, researchers, hospitals, and health systems.  Importantly, pathologist contributors highlight insights and observations on the future of the field in each chapter.  The emerging area of rapid research autopsy is also presented from the perspective of both the science and the performance of this new area of autopsy development.  Autopsy in the 21st Centuryprovides guidance for readers to embrace transformations that are already taking place in the field of autopsy pathology.