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How Did Al Capone Die? Inside The Legendary Chicago Mobster’s Last Years

Published April 30, 2020
Updated June 6, 2020

By the time of Al Capone's death, the 48-year-old had deteriorated so severely from the advanced syphilis ravaging his brain that he had the mental capacity of a 12-year-old boy.

There’s a reason why the name Al Capone is so well known today. The stout, cigar-chomping mobster has inspired countless films, pieces of literature, musicians, and, of course, criminals.

While there were comparable crime figures in the 1920s, the Chicago mobster truly stood out from the pack. In terms of his impact on the underworld, Capone rose from being a street thug to the FBI’s “Public Enemy No. 1” in the span of about a decade.

His strange death, of course, further differentiated him from his peers. While he was still a low-ranking gangster and bouncer at a bordello, he contracted syphilis. He chose to leave this disease untreated, which ultimately led to an untimely demise at age 48.

Up until recently, Al Capone has mostly been famous for all the little details of his prime time as a gangster: his plump, smiling face gnawing on a cigar, his hearty laughter at a baseball game, and his now-iconic pinstriped suits and fashionable hats.

Al Capone took the image of the gun-wielding outlaw and modernized it for a new age. He made himself into the king of the gangsters — who served as an uncompromising middle finger to the Prohibition Era.

But it’s the dismal final chapters of his life that will be explored in the upcoming film Capone. By the time of Al Capone’s death, the once fearsome mobster was all but unrecognizable.

How Syphilis And Madness Set The Stage For Al Capone’s Death

Al Capone Fishing In A Robe

Ullstein Bild/Getty ImagesThe former mob boss was reduced to the mental capacity of a 12-year-old child in his final years.

Al Capone was born to Teresa Raiola and a barber named Gabriel on Jan. 17, 1899 in Brooklyn, New York. Capone’s parents had emigrated from Naples and worked remarkably hard, only for their son to hit a teacher and get kicked out of school at age 14.

As an aspiring young criminal, Capone ran roughshod on whatever gamble he could make. From loansharking to racketeering to gunning down the competition, it was his ambition that propelled him forward. But it wasn’t a dangerous shootout that did him in. Rather, it was his early job as a bouncer for one of “Big Jim” Colosimo’s bordellos.

Before Prohibition officially started in 1920, Capone was already making a name for himself when Johnny Torrio — someone he considered a mentor — recruited him to join Colosimo’s crew in Chicago.

At one point, Colosimo was earning around $50,000 per month from the flesh trade.

Saint Valentines Day Massacre Aftermath

Bettmann/Getty ImagesOn Feb. 14, 1929, seven members of the North Side Gang were shot to death in a garage by men believed to be associates of Al Capone’s crew.

Eager to try the business’s offerings, Capone “sampled” many of the prostitutes working at his boss’s whorehouse and contracted syphilis as a result. He was too ashamed to seek treatment for his disease.

He soon had other things on his mind besides the harmful microbes boring into his organs. So Capone focused on colluding with Torrio to murder Colosimo and take over the business instead. The deed was done on May 11, 1920 — with Capone highly suspected of involvement.

As Capone’s empire grew throughout the decade, with infamous mob hits like the Saint Valentine’s Day Massacre adding to his mythos, so did his syphilis-induced madness.

When authorities finally nailed Capone for tax evasion on Oct. 17, 1931, he was sentenced to 11 years in prison, during which time his cognitive deficiencies and emotional tantrums worsened.

Alcatraz Mug Shot Of Al Capone

Donaldson Collection/Michael Ochs Archives/Getty ImagesAlcatraz opened in 1934, with Al Capone being one of its first inmates. Aug. 22, 1934. San Francisco, California.

Capone spent about eight years behind bars, notably at Alcatraz upon its opening in 1934. As the neurosyphilis plagued his intellectual abilities, he increasingly failed to follow orders.

So Capone’s wife Mae pushed to have him released. After all, the man had started to dress up in a winter coat and gloves inside his heated jail cell. In February 1938, he was formally diagnosed with syphilis of the brain.

Capone was released on Nov. 16, 1939, on the grounds of “good behavior” and his medical condition. He spent the remainder of his days in Florida, where his physical and mental health deteriorated even further.

How Did Al Capone Die?

The ailing mobster was referred to Johns Hopkins Hospital in Baltimore for his paresis — an inflammation of the brain caused by the later stages of syphilis. But Johns Hopkins Hospital refused to admit him, leading Capone to seek treatment at Union Memorial.

The sickly ex-convict left Baltimore in March 1940 for his Florida home in Palm Island.

Palm Island Florida Home Of Al Capone

Fox Photos/Getty ImagesCapone’s Palm Island home, which he bought in 1928 and lived in from 1940 until his death in 1947.

Though the retired gangster became one of the first patients in history to be treated with penicillin in 1942, it was too late. Capone had begun regularly hallucinating and suffering from seizures similar to those of epileptics.

While Capone’s health deteriorated as he regularly visited the Dade County Medical Society, he was unaware the FBI had sources planted in the facility to observe him in the midst of his illness.

One agent described a session as Capone babbling gibberish in “a slight Italian accent,” the memo read. “He has become quite obese. He is of course shielded from the outside world by Mae.”

“Mrs. Capone has not been well,” primary physician Dr. Kenneth Phillips later admitted. “The physical and nervous strain placed upon her in assuming the responsibility of his case is tremendous.”

FBI File Of Al Capone

Wikimedia CommonsAl Capone’s FBI file in 1932, showing most of his criminal charges as “dismissed.”

Capone still enjoyed fishing and was always sweet when children were around, but by 1946, Dr. Phillips said that his “physical and nervous condition remains essentially the same as when last officially reported. He is still nervous and irritable.”

In the last months of that year, Capone’s outbursts lessened, but he still got aggravated sometimes. Besides occasional trips to the drugstore, Mae Capone kept her husband’s life as quiet as possible.

He spent his last year mainly in pajamas, searching the property for his long-lost buried treasure, and engaging in delusional conversations with long-dead friends, which his family often went along with. He was overjoyed at drugstore trips as he had developed a childlike glee over Dentyne gum.

The FBI file noted in 1946 that “Capone then had the mentality of a 12-year-old child.”

It was on Jan. 21, 1947, that he suffered a stroke. His wife called Dr. Phillips at 5 a.m., who noted Capone’s convulsions occurred every three to five minutes and that his “limbs were spastic, his face drawn, pupils dilated, and eyes and jaws were set.”

Al Capone Smoking In His Robe

Ullstein Bild/Getty ImagesThough Capone was treated with penicillin, it was too late to reverse the damage to his brain.

Medication was administered, and in a couple of days, Capone went without a single seizure. The paralysis on his limbs and face had abated. But unfortunately, he was concurrently dealing with bronchial pneumonia.

This caused him to worsen, albeit not as viscerally as the previous spasms, despite the oxygen, penicillin, and the other medicines he was given.

After cardiac specialists gave him digitalis and Coramine in hopes of curing the pneumonia and slowing the progression of his heart failure, Capone began drifting in and out of consciousness. He had a moment of clarity on Jan. 24, which he used to assure his family that he would get better.

Mae arranged for Monsignor Barry Williams to administer her husband’s last rites. On Jan. 25 at 7.25 p.m., “with no warning whatsoever, he expired.”

Understanding Al Capone’s Cause Of Death

Al Capone’s death was anything but simple.

His end arguably began with his initial contraction of syphilis, which had steadily burrowed into his organs for years. It was his stroke, however, that allowed the pneumonia to take hold within his body. That pneumonia preceded the cardiac arrest that ultimately killed him.

Al Capone Laughing While Wearing A Bathing Suit

Ullstein Bild/Getty ImagesCapone spent his last years chatting with invisible guests and searching for his missing treasure.

Dr. Phillips wrote in the “primary cause” field of Capone’s death certificate that he died of “bronchial pneumonia 48 hours contributing apoplexy 4 days.”

Only the obituaries revealed the “paresis, a chronic brain disease causing loss of physical and mental power,” with the underlying neurosyphilis being left out entirely. Rumors that he had died from diabetes rather than syphilis floated around the world for years.

Ultimately, the true series of events made complete sense. Al Capone had degenerated to the mental capacity of a 12-year-old because the untreated syphilis had attacked his brain for years.

The stroke he experienced in 1947 weakened Capone’s immune system so thoroughly that he couldn’t fight off his pneumonia. So he suffered cardiac arrest as a result of it all — and died.

The official trailer for CAPONE, starring Tom Hardy as the eponymous gangster. The film is set to be released on May 12, 2020.

In the end, his loved ones offered the world an obituary as memorable as the gangster’s iconic personality:

“Death had beckoned to him for years, as stridently as a Cicero whore calling to a cash customer. But Big Al had not been born to pass out on a sidewalk or a coroner’s slab. He died like a rich Neapolitan, in bed in a quiet room with his family sobbing near him, and a soft wind murmuring in the trees outside.”


After learning about the real story behind Al Capone’s death, read about mobster Billy Batts’ murder. Then, learn about the short life of Frank Capone, Al Capone’s brother.

Marco Margaritoff
Marco Margaritoff is a Staff Writer at All That Is Interesting.