Anabolic androgenic steroids (AAS) use is widespread not only among athletes and sportsmen but also in different populations, including young people who use them for aesthetic purposes, to boost muscles, and sculpt the body.In many instances, the medications purchased through illegal channels are unreliable because they may contain ingredients of low quality or in the wrong doses, be deliberately and fraudulently islabeled with respect to their identity or source, have the wrong ingredients, or have low levels of active ingredients.In this paper, the toxicol., histol., and medico-legal findings of an AAS user who died of a cause unrelated to AAS abuse (road accident) are reported, with a special focus on the usefulness of hair anal. to uncover PIED administration.A 46-yr-old male died in a road accident while driving a motorcycle due to aggressive driving with reckless overtaking after an altercation with another driver.Hair specimens, different AAS were identified, in particular, stanozolol, trenbolone, testosterone enanthate, testosterone, and sildenafil.In the urine sample, the main stanozolol metabolite 3-hydroxystanozolol and desmethylsildenafil were detected.Caffeine was present in both hair and urine samples.Histopathol. and toxicol. findings for an AAS user, who died after the consequences of a road accident, showed the adverse effects likely due to AAS abuse on various organs.The heart, liver, and renal alterations were consistent with a wide and repeated use of AAS, as reported in the literature.Hair anal. demonstrated a continuative use of various AAS and sildenafil.This fact would have gone unnoticed without the hair anal., given the unrelated cause of death and their absence in blood and urine.This case demonstrates the usefulness of hair anal. to obtain a complete evaluation of each forensic case.The analyses performed on falsified medicines in the victim's possession confirmed that the actual qual. content lacks consistency with what was declared on the label.