Although the increasing popularity of tattoos has challenged the previous associations with criminality and psychiatric illness, particular subsets of tattooed individuals may still have an association with unnatural deaths in a forensic context. A retrospective review of the autopsy database at Forensic Science South Australia was undertaken over a 23-year period from 1997 to 2019 for cases with swastika tattoos. Twenty-six cases (23 males and 3 females) were identified, ranging in age from 19 to 67 years ( Mage = 36 years). The cases comprised seven (27%) suicides, seven (27%) accidents (including five vehicle crashes), five (19%) drug-related deaths (toxicity/overdose), four (15.4%) natural deaths and three (11.5%) homicides. There were significantly more unnatural deaths in the group with swastika tattoos compared to tattooed controls ( p < 0.01). Multiple swastikas, expletives and white supremacist sentiments were also present in a number of cases. However, in one Asian male, the presence of a sacred Buddhist tattoo suggested that the swastika tattoo instead had religious rather than antisocial/racist significance. This study shows that in the population of individuals undergoing forensic autopsies, subgroups may be identified by their tattoos who have a predisposition to violent and unnatural death. Evaluation of this risk has to be tempered by considering the cultural/religious background of a decedent, as the symbol may have completely different connotations for certain religious groups such as Jains, Hindus and Buddhists.