In this publication 125 years after the violent death of the famous Empress Elisabeth (1837-1898) of Austria, known as Sisi, a modern evaluation as well as valuation will be presented. The day after her assassination by the young anarchist Luigi Lucheni using a file, a partial autopsy was performed to find out the exact cause of death-a pericardial tamponade. The complete translation of the autopsy report is part of this article, the intention being to avoid unclear wording and translation errors, which have often caused some confusion in the past. A pictorial illustration of the puncture canal will provide clarity through medical facts as to how Empress Elisabeth's death came about by correct pathological and anatomical description and, thus, counteract former interpretations.