In some ways, the pediatric forensic pathologist often walks a diagnostic tightrope-deciding between SIDS and smothering, between inflicted closed-head injury and spontaneous intracranial hemorrhage, or between preeclampsia and maternal blunt trauma precipitating placental abruption. Toward that end, it is equally important to be aware of the limitations of a particular case and not offer opinions beyond what the circumstances and pathologic evidence allow. In some situations, “undetermined,” while unsatisfying, is at the same time the fairest and most reasonable ruling until additional information is obtained that allows a more definitive ruling.