Inside Alexander The Great’s Death And His Mysterious Affliction Before Potentially Being Buried Alive

Published January 30, 2019
Updated June 10, 2022

While historians have long posited a wide range of theories regarding his death, new studies might answer the ancient mystery of Alexander the Great's death once and for all.

Alexander The Great Death

Wikimedia CommonsAlexander the Great’s death has mystified historians for centuries.

Alexander the Great’s death in 323 B.C. has flummoxed historians for millennia. The ancient Greeks were baffled as to how the king’s body hadn’t begun to decompose six days after he was pronounced dead. His contemporaries ruled him a deity as a result, while new theories might hold answers more rooted in reality.

With an empire stretching from the Balkan Peninsula in southeastern Europe to modern Pakistan in the Middle East, Alexander the Great became one of the most renowned figures in history. He was poised to conquer even more territory before falling mysteriously ill — and dying in Babylon after 12 days of pain.

Ancient doctors relied solely on physical movement and the absence or presence of breath to determine if a person was even dead. The Greek king showed neither of those signs yet wasn’t decomposing — leading historians to theorize his cause of death was either malaria, typhoid, alcohol poisoning, or assassination.

New research has provided the most rational theory to date, however. Dr. Katherine Hall from the Dunedin School of Medicine at the University of Otago believes the 32-year-old died from an autoimmune disorder called Guillain-Barré Syndrome — which left him paralyzed and seemingly dead for days before he was.

The Rise And Rule Of Alexander The Great

Alexander the Great was born on July 20, 356 B.C., in Pella, Macedonia. His father was King Philip II of Macedon. His mother Queen Olympia was the daughter of King Neoptolemus. Raised in the royal court alongside his sister Cleopatra, Alexander resented that his father was constantly gone for faraway battles.

Macedonian Phalanx In Battle Of The Carts

Wikimedia CommonsAlexander’s armies battling Thracian tribes in 335 B.C.

His relative Leonidas of Epirus educated the young prince in matters of math, archery, and horsemanship. Alexander was fascinated by the Greek warrior god Achilles. His father hired Aristotle himself in 343 in order to teach Alexander at the Temple of the Nymphs about philosophy, drama, poetry, science, and politics.

One year after completing his studies in 340, the teenage prince became a soldier. He led the Companion Cavalry to help defeat Athenian and Theban armies with his father in 338. While King Philip II had united every Greek state save for Sparta, he ousted his wife to marry Cleopatra Eurydice — to Alexander’s wrath.

Alexander and his mother escaped before returning for his sister’s wedding in 336. It was during those celebrations that King Philip II was murdered by a Macedonian noble and 19-year-old Alexander was proclaimed king. His mother subsequently drove her ex-husband’s wife to suicide and killed her daughter.

By 336, Alexander gained full control of the military. He led 3,000 cavalry and 30,000 infantry to secure Thebes, invaded Asia Minor, and saw powerful city-states like Athens pledge allegiance. His campaign against Persia culminated in his capture of King Darius III in 333 — with a subsequent focus on Egypt.

Alexander The Great Death Funeral Procession

Wikimedia CommonsAn interpretation of Alexander’s funeral procession.

He created Alexandria as a Greek center of arts and culture in 331 as the Persian army collapsed. He then developed colonies in Iran and India. In an effort to satisfy his newfound subjects in 325, he ousted tens of thousands of Macedonian soldiers and replaced them with Persians — to the frustration of former loyalists.

The Death Of Alexander the Great

Before Alexander the Great died, he had met an Indian ascetic philosopher named Calanus. The elderly man agreed to teach Alexander and follow him back to Babylon, but the journey was so arduous that he committed suicide. Before dying of self-immolation, Canalus said, “We shall meet in Babylon.”

Alexander the Great’s death began slowly in 323. He arrived in Babylon and celebrated with naval officer Nearchus and continued drinking the next day. A sudden fever and back pain followed before he grew increasingly immobile and couldn’t lift his limbs. Before he grew incapable of speech, he issued instructions.

Alexander the Great ordered that only the most esteemed doctors should carry his coffin, his fortune be scattered along the road of his funeral procession, and that his hands should hang outside of his coffin for onlookers to witness. Alexander explained each of these wisely as only a student of Aristotle could.

Painting Of Alexander The Great Death

Photo 12/Universal Images Group/Getty ImagesA painting depicting Alexander’s death in Babylon.

He said that even the best physicians can’t save somebody from dying, that earthly possessions mean nothing in the end, and that people come into this world empty-handed — and should depart it as such. Pronounced dead on June 10 after 12 days of suffering, he didn’t show signs of decomposition for six days.

“His body, although it lay without special care in places that were moist and stifling, showed no sign of such destructive influence, but remained pure and fresh,” wrote Plutarch, a Greek philosopher and the biographer who chronicled Alexander’s death centuries later.

Alexander the Great’s body was placed in a gold sarcophagus filled with honey, which was then placed in a gold casket. His casket was seized by Ptolemy during the funeral procession to Macedon and then brought to Alexandria. Ultimately, researchers have yet to locate Alexander the Great’s tomb — and identify his cause of death.

How Did Alexander The Great Die?

Practicing physician and senior lecturer Dr. Katherine Hall believes Alexander the Great had Guillain-Barré Syndrome (GBS) and died from its untreated symptoms. The neurological disorder certainly would explain why the king wasn’t decomposing for days — as GBS renders one paralyzed and visibly appearing dead.

Sarcophagus Of Alexander The Great

Wikimedia CommonsAlexander’s purported sarcophagus, found during excavations in 1887 at a necropolis near Sidon, Lebanon.

According to her theory in The Ancient History Bulletin, Alexander developed a “progressive, symmetrical, ascending paralysis” during his last days. She posited that he contracted GBS from an infection of Campylobacter pylori, a common bacterium of his time — and treated today with antibiotics.

Hall believes that the conqueror’s strange symptoms such as fever, abdominal pain, and progressive paralysis didn’t rob him of his cognitive functions. This suggests Alexander had a completely sound mind while immobile — and was potentially buried alive after being falsely declared dead for an entire week.

While her “false diagnosis of death” (or pseudothanatos) theory is well-founded, others believe Alexander died of more commonly understood diseases or assassination, which Plutarch rejected as a theory. In the end, only an analysis of his bones could solve the mystery — with the quest for his tomb ongoing to this day.

After reading about this new theory on how Alexander the Great died, take a look at declassified satellite images showing the lost city of Alexander the Great in modern-day Iraqi-Kurdistan. Then, read about Alexander the Great’s bad-ass mother, Olympias.

Marco Margaritoff
A staff writer for All That’s Interesting, Marco Margaritoff has also published work at outlets including People, VICE, and Complex, covering everything from film to finance to technology. He holds dual bachelor's degrees from Pace University and a master's degree from New York University.