3 potential causes of Alexander the Great`s death

Alexander the Great is widely seen as one of the most influential men of all time. His incredibly fast conquest of the Persian empire, the curiosity that pushed him to march further and further east, but also his death at the young age of 32 years old, and the circumstances of his death make him a mystery to this day.

But while the life and the wars of Alexander the Great are well known, the same can not be said about his death. Questions like „What exactly caused the death of Alexander the Great?“ or „What happened to his body?“ have been debated since the day he died.

The following article will present the three most common explanations for the death of Alexander the Great while the article that you can find here will dive into the question of what happened to the body of the great general immediately after his death, during the wars of the Diadochi, and during the time of the Roman Republic & the Roman Empire.

In early June of 323 BC, Alexander caught a fever after an evening of heavy drinking. After one week he was barely responsive and would be unconscious for the last 3 days before his death. Following the Babylonian astronomical diaries, Alexander the Great died on 11 June 323 BC between 4:00 PM and 5:00 PM at the age of 32 in the palace of Nebuchadnezzar II in Babylon. The fever might have been caused by Malaria Tropica or typhoid fever, alcohol poisoning, or poisoning.

Let`s find out more!

Disclaimer: This post contains affiliate links that are identifiable by the *. If you use these links to buy something we may earn a small commission without additional cost for you. Thanks.

When & Where did Alexander the Great die?

Depending on if you look at our modern-day calendar or the Babylonian astronomical diaries there are two dates for the death of Alexander.

According to the Babylonian astronomical diaries Alexander the Great died on 11 June 323 BC between 4:00 and 5:00 PM. The modern Calendar sets 10 June 323 BC as the date of Alexander`s death. He died in the palace of Nebuchadnezzar II in  Babylon after falling sick and not being able to talk for several days.

And while the date of his death is well known, really well known if you consider that we even have the time of death, the cause of death has been debated since the day he died.

In the following, I would like to present the 3 most likely scenarios that led to the death of Alexander the Great. But before we talk about the death of Alexander: Are you also interested in the life of Alexander the Great?

Then you might want to check out the biography of Alexander the Great that was written by the ancient Roman writer Plutarch (and that is still one of the most important sources for our knowledge about Alexander). You can find a translated version here* on Amazon.

Potential causes of Alexander the Great`s death

There are basically 3 potential causes of death that have been connected to the untimely death of Alexander the Great. That untimely death and the lack of an (undisputed) successor was actually one of the reasons why his empire would break apart. Here you can find out more about the other two reasons!

While there are good arguments for both alcohol poisoning and a death that was caused by disease (there are different diseases that might have killed him, more on that in a minute) the arguments for Alexander being murdered are much rarer. Because of that, I would like to start with murder as a potential cause of death.

Murder through poisoning

The idea that Alexander the Great did not die of a natural cause was mostly spread by his mother Olympias and should become extremely important during the wars that would follow the death of Alexander. You can find out more about these wars and what eventually happened to the empire of Alexander the Great in my article here.

Especially Olympias, the mother of Alexander, spread the idea that Alexander had been poisoned by Antipater and Cassander. The fact that despite the summer heat in Babylon, the body of Alexander did not start to show any signs of decomposition until a few days after his death is oftentimes also seen as an argument that speaks for poisoning.

The idea that Antipater and his son Cassander poisoned the king is mostly based on the fact that Alexander had ordered Antipater, who had been ruling over Macedonia in Alexander`s stead during Alexander`s entire conquest of the Persian empire, to leave that position and join the following campaigns.

Admittedly, the order to leave a comfortable and secure position as regent over Macedonia to join a campaign into Arabia and eventually also west to Carthage was probably not met with extreme excitement by Antipater and his son. But was that really enough for plotting a murder?

It seems more likely that the story of Antipater and Cassander murdering Alexander was created and spread with a different goal in mind.

The empire that Alexander had conquered within 10 years would quickly break apart after his death, here you can find out the 3 reasons for that. What followed was a fight for power between the former generals of Alexander the Great in which Olympias, his mother, also took part. And the accusation that Alexander had been poisoned would play a significant role in the wars over the empire, more on that here.

Another much more probable cause of death is disease. And several diseases might have caused Alexander`s death.


While poisoning might seem pretty far-fetched, the idea that a disease caused the fever that would eventually kill Alexander is the most natural.

Especially typhoid fever and malaria Tropica, both diseases are known to have circulated in Babylon, seem like natural candidates since both of them cause high fever, exhaustion, and sweats. And these symptoms match the antique accounts of Alexander`s condition pretty well.

Now one might ask how an infectious disease could kill a young, 32-year-old man in his prime and at peak health.

Well, not only did the massive alcohol consumption probably not help. Additionally, Alexander had also been almost fatally injured during his Indian campaign. Alexander had been shot with an arrow during the siege of an Indian castle. That arrow had entered his chest right over his right nipple and had injured his lung. It is actually impressive that he was able to survive such a wound.

But he did not survive that injury without any aftereffects, I think it is pretty safe to say that Alexander was not in his best health (not really a surprise after over 10 years of war and 4 light, 3 serious, and the one already mentioned almost fatal injury).

But there is one more potential candidate that might have caused the fever. And that candidate has already been hinted at when I talked about how massive alcohol consumption might have weakened Alexander.

Alcohol poisoning

Another possible cause of death that has already been debated during antiquity might have been alcohol poisoning.

The ancient Roman writer Plutarch wrote, that, during the night before the fever that eventually killed him broke out, Alexander had participated in heavy drinking.

That kind of heavy drinking was not unusual, there are a lot of situations in which ancient writers describe incidences in which Alexander and his friends would drink a lot and what consequences that could have. A good example of that is a feast in the year 328 BC during which an intoxicated Alexander killed Cleithos, a friend of his and one of his generals, over a disagreement.

By the way, when Alexander was sober again he regretted killing Cleithos so much that he, according to some sources, had to be kept from committing suicide.

Another example would be the return from the campaign into India, more on whether or not Alexander really reached modern-day India in my article here. Alexander stylized his return as a Dionysian procession by sitting together with his closest friends on a wagon that was drawn by 8 horses. He and his closest friends would spend the last 7 days and nights on the journey back to Babylon on this wagon with heavy drinking.

So with that in mind, it does not seem out of the realm of possibility that an invisible enemy, the alcohol, caused the fever that would eventually kill Alexander the Great.

But no matter how he died, his body would still be and remain highly valuable for centuries. Especially during the wars of the Diadochi possession of the body of Alexander was seen as a way to legitimize one’s own rule. More on how the body of Alexander could legitimize a successor in my article here.

And that brings us to one final question: What happened to the body of Alexander the Great? Please check out my article here for more information on the fate of Alexander the Great`s body and how several Roman emperors (mis-) behaved around his body.

Take care of yourself because you deserve it. You really do.

Until next time

Yours truly

Luke Reitzer


G.R Bugh: The Cambridge Companion to the Hellenistic World (Cambridge 2006).

R. Malcom Errington: A History of the Hellenistic World (Malden 2008).

G. Shipley: The Greek World after Alexander (London, New York 2000).