A 60 year old female died suddenly, probably due to arrythmia. At autopsy, cerebral softening from the hypothalamus to the central thalamic nuclei was seen. This was thought to be secondary to a cerebrovascular accident with consequent poikilothermia. During the clinical course, ECG findings characteristic of hypothermia such as sinus bradycardia, bradic atrial fibrillation, prolongation of QT interval, T wave inversion and appearance of J wave (Osborn wave) were noted in association with cold weather. The case is discussed with a review of the literature.