A fatal case of a 44-year-old man is presented. Ethanol was detected in the body (blood alcohol concentration – 2.0 g/l; urine alcohol concentration – 2.3 g/l) and the concentrations (expressed in μg/ml or μg/g) of cocaine and its pharmacologically active metabolite – ethylcocaine (cocaethylene) – amounted to: 1.38 and 0.17 in blood, 13.57 and 0.82 in urine, 296.60 and 0.87 in stomach with content, 150.90 and 1.30 in small intestine, 28.86 and 6.64 in liver, 14.24 and 1.47 in kidney and also 13.18 and 0.95 in brain, respectively. Moreover, an inactive metabolite of cocaine, i.e. benzoylecgonine, was detected. Low levels of other drugs were also found and their blood concentrations (in μg/ml) were as follows: nordazepam – 0.08, disulfiram – 0.14 and paracetamol – 1.38. The findings indicated that the death of the man was caused by combined cocaine and ethanol poisoning.