How Did Alexander the Great Die?


1. What the Ancient Sources Actually Say


Plutarch, Arrian and Diodorus—writing three to four centuries after 323 BCE—agree on a tale of “fever after heavy drinking” that worsened until Alexander could no longer speak. Plutarch adds that his body reportedly showed no decay for six days, a detail that fuels both divine-sign legends and modern medical speculation. Live Science

A Day-by-Day Symptom Diary (June 1–11, 323 BCE)


DayRecorded events*
1–2All-night banquet; stabbing stomach pain
3–5Remittent high fever, chills, exhaustion
6–7Forced to be carried on a litter; still issues orders
8–9Unable to walk; acute abdominal agony
10Loses power of speech
11Dies in palace of Nebuchadnezzar II, Babylon

*Compiled from Ephemerides references and late classical biographies.


2. Modern Medical Theories—Side-by-Side


Leading TheoryKey EvidenceWeak PointsNotable Scholar(s)
Typhoid feverFits fever curve, abdominal pain, stupor; endemic in Babylon; can cause “ascending paralysis” that mimics death.Would likely infect others at court, yet no mass outbreak recorded.David Oldach, Univ. of Maryland 1998 ScienceDaily
Malaria (Plasmodium falciparum)Intermittent fever noted; Alexander sailed mosquito-rich marshes days earlier.Doesn’t explain delayed decomposition.Andrew Chugg, Ancient History Bulletin Wikipedia
Guillain-Barré SyndromeExplains paralysis while remaining conscious and slow body decay; could follow a Campylobacter infection.Extremely rare; ancients didn’t describe hallmark limb numbness.Katherine Hall, 2019 study ScienceDaily
Strychnine/arsenic poisoningSudden onset, speechlessness, rigid jaw noted by Plutarch & Arrian.Lack of similar symptoms in companions; no proof of motive succeeds.Live Science report 2025 Live Science
Acute necrotizing pancreatitisMatches alcohol binge + gall-stone pain; modern retro-diagnosis.No ancient mention of jaundice or vomiting blood.Medical review 2022 PMC

3. The Poison Plot—History’s Favorite Whodunit


  • Prime suspects: General Antipater (via son Iollas the cup-bearer), Queen Roxana, even Aristotle.
  • Delivery methods proposed: ‟Horse-hoof vial” of strychnine, wine laced with arsenic or hellebore.
  • Counter-argument: Most poisons in antiquity killed in hours, not eleven days; no co-victims reported. Live ScienceWikipedia

4. Could He Have Been Declared Dead Too Early?


A GBS-induced “locked-in” state could render breathing shallow enough to fool 4th-century BCE physicians, explaining the famed six-day preservation myth. ScienceDaily


5. Why We May Never Be Certain


  1. Lost Autopsy: No extant contemporary autopsy or mummy.
  2. Agenda-ridden Sources: Later writers shaped narratives to suit political heirs.
  3. No Tomb: The conqueror’s burial place remains elusive, depriving us of DNA or bone isotope tests.

Still, multidisciplinary scholarship keeps refining probabilities—today’s consensus leans toward infectious disease (typhoid or malaria) complicated by prior war wounds over straight poisoning.


Fact-Check Box


ClaimVerdictNotes
Alexander died of typhoid fever.PlausibleBacked by 1998 University of Maryland study.
He was assassinated with poison.UnprovenNo physical evidence; motive debates continue.
He was buried in Alexandria.LikelyAncient sources say body moved there, but tomb lost.

Frequently Asked Questions


In the palace of Nebuchadnezzar II, inside Babylon (near modern Hillah, Iraq). Live Science
Exactly 32 years and eight months—born July 356 BCE, died June 323 BCE.
If the GBS theory is right, Alexander wasn’t fully dead at first; minimal blood flow and respiration can delay decomposition. ScienceDaily
Possible, but most toxicologists note the timeline (11 days) is too long for known ancient poisons; evidence is circumstantial. Live Science
Yes—recovering confirmed remains could allow pathogen DNA or heavy-metal testing, but the tomb’s location is still unknown.