The anthracycline anticancer drug Doxorubicin (Adriamycin) is an effective and frequently used chemotherapeutic agent for various malignancies. The use of doxorubicin is limited by its major adverse effect, cardiotoxicity. Doxorubicin cardiomyopathy, once developed, carries a poor prognosis with a mortality rate of over 50%. Although invasive, histopathologic analysis of myocardial tissue remains the most sensitive and specific method of diagnosing doxorubicin cardiomyopathy. Histopathologic analysis reveals not only the char acteristic diagnostic features of the disease but also aids in grading the severity of doxorubicin cardiomyopathy, which guides further therapy. We report the autopsy findings of a 31-year-old man with a history of T-cell Acute Lymphoblastic Leukemia (ALL) who died of severe doxorubicin induced dilated cardiomyopathy after he was given multiple rounds of hyperfractionated Cyclophosphamide, Vin cristine, Adriamycin (doxorubicin) and Dexamethasone (hyper-CVAD) over a period of six years.