The aim – to explore morphological changes of coronary arteries with severe tortuosity in children. Four autopsy cases of severe coronary artery tortuosity are presented: three cases of intrauterine fetal death (two male patients and one female, at the gestation age of 28, 29 and 39 weeks) and the autopsy case of one-year-old boy. Morphological changes of the coronary arteries were examined by standard histological and histochemical methods (hematoxylin-eosin, Masson’s trichrome, Hart’s elastic stainings). Severe tortuosity of the anterior descending coronary artery was prevalent (in three cases). Detection of tortuous coronary arteries in fetuses, who died prenatally, indicates the congenital genesis of this vascular anomaly.