The scientific understanding of cetacean pathology has advanced significantly in recent decades. However, data concerning the health status of members of the family Kogiidae remain scarce. This study presents a comprehensive pathological assessment and determination of causes of death in 45 stranded kogiids, comprising 35 Kogia brevi-ceps and 10 K. sima, along the coasts of the Canary Islands between 1999 and 2018. Causes of death (CD) were classified as natural (30/45; 66.6%) or anthropogenic (11/45; 24.4%), while the cause remained undetermined in 4 cases (9%). Among natural causes, the most prevalent etiologies included trauma (13/30; 43.3%), infectious (7/30; 23.3%), parasitic (5/30; 16.6%), cardiomyopathy (3/30; 10%), malnutrition (1/30; 3.3%), and fetal distress (1/30; 3.3%). Anthropogenic causes were vessel collisions (7/11; 63.6%), interactions with fishing activities (2/11; 18.2%), and foreign body-associated pathology (2/11; 18.2%). Notably, intra-interspecific traumatic interactions were overrepresented in this cohort, and variable degrees of gross and histologic cardiomyopathic changes were observed in 68.9% of individuals (31/45) without evident sex bias. Septicemia caused by Clostridium perfringens and Cl. tertium was confirmed in three cases. Additionally, cervical gill slit adenitis by Crassicauda sp. (15/45; 33%) and parasitic gastritis by Anisakis sp. (27/45; 60%), were frequent findings. These findings provide novel insights into the pathologic spec-trum affecting kogiids and enhance the current understanding of their health status, with implications for diagnostic protocols, stranding response, and conservation strat-egies.