An incomplete fatal trepanation diagnosed on cremation remains (Rome, Italy, 2nd c. AD).

Background: An original case of incomplete (and reasonably fatal) human trepanation is described in this short paper. The diagnosis was made on the cremated remains of a young adult individual who died in Rome, Italy during the 2nd century AD.

Clinical Presentation: The trepanation was incomplete, as death occurred quickly due to vascular lesions, according to the anatomic analysis of the bone piece. Comparable trepanation from Roman times are described and related to this case.

Conclusion: Even if archaeological, this case highlights the possibility of such a diagnosis on post-fire fragmented bones. Very suggestive lesions of section are of great interest for the history of such a practice during classical Antiquity. Lastly, from a medical and forensic point of view, such a diagnosis may be of interest during any identification process and research for a cause of death during anthropological analyses.