Coronary artery ectasia (CAE), whether it is diffuse or localized, is an uncommon finding. It is sparsely documented, especially by post-mortem imaging and histology. In this article, we will describe two cases of sudden cardiac death secondary to coronary thrombosis in the context of CAE. The cause of death was myocardial infarction in both cases. Diagnosis was based on post-mortem computed tomography angiography, forensic autopsy, and histological examination, offering a rare and complete illustration of the disease.