The risk to pathologists of contracting diseases due to cuts or needles punctures while performing autopsies is well known. An additional risk is an accidental needle puncture due to retained needle fragments within the subcutaneous tissues or internal organs of intravenous drug addicts. We report 4 cases of drug addicted patients infected with human immunodeficiency virus who came to autopsy and had retained needle fragments within their cervical-clavicular soft tissues. The presence of retained needle fragments increases the risk to the autopsy pathologist of accidental needle puncture and exposure to disease. Because of this phenomenon, the pathologist should take precautions in addition to those currently prescribed when performing autopsies on possible drug abusers.