Starvation to the death is only an exceptionally cause of death in developed countries. However, this phenomenon can have a far greater significance if the court-medically speaking death is a consequence of deliberate denial of food, especially if the children are affected. These are the examples from the literature that we quote in this paper, with a review of elderly people as an additional special endangered group. In such cases, the task of a specialist of forensic medicine or pathologists is to clarify the cause of death and give expert opinion on the degree and duration of hunger. Also, in the paper we quote signs of starvation in autopsy which is crucial for declaring starvation as the cause of death. We mentioned Waterlow and Gomez classification systems that were primarily designed to assess protein-energy malnutrition in third world countries but who found their use in forensic medicine. We also mention the duration of starvation depending on the type of starvation, or whether the victim consumed water. There will be a few words on a physical condition before death and establishing an immediate cause of death which in these cases is sometimes difficult to determine, especially if there is still some additional pathology, or if a person is suffering from a disease that is not caused by starvation.