How Did Alexander the Great Die? | History Hit

How Did Alexander the Great Die?

James Carson

11 Jul 2018
A 1st century Roman mosaic of Alexander the Great fighting at the Battle of Issus.

Amongst the military leaders of history, Alexander the Great might well be considered the most successful and influential.

As King of Macedon and Hegemon of the League of Corinth, he began a campaign against the Persian Achaemenid Empire in 334 BC.

Through a series of stunning victories, often with fewer troops than his enemy, he overthrew Persian King Darius III and conquered the Achaemenid Empire in its entirety.

He then invaded India in 326 BC, but after further victory turned back due to the demands of mutinous troops.

In little over 10 years, his campaigning won the ancient Greeks an empire stretching some 3,000 miles from the Adriatic to the Punjab.

Alexander’s empire stretched from Greece to Egypt in the south and into modern day Pakistan in the east.

And all of that by the age of 32. But as he crossed back through modern day Iraq and spent time in the city of Babylon, Alexander died suddenly.

His death is a controversial point for historians – how did one of history’s most successful generals die so young? There are three main theories surrounding his demise, each with many fine details.


It seems very likely that Alexander was a heavy drinker, and there are tales of big drinking contests amongst his troops, which he often partook in and even organised.

In 328 BC, there was an infamous drunken brawl between Alexander and his friend Cleitus the Black, who had previously saved his life at the Battle of Granicus. This escalated into Alexander killing Cleitus with a javelin.

Alexander kills Cleitus, painting by André Castaigne 1898–1899.

One account of his death said it came after downing a bowl of unmixed wine, in honour of Heracles, and that he was bedridden for eleven days and died without a fever.

A natural ailment

Alexander had been campaigning for over a decade and travelled 11,000 miles.

He had fought in some huge battles, and his desire to lead the line and get into the midst of the fighting meant he likely had some heavy wounds.

All of this, combined with his heavy drinking, would have taken a significant physical toll on the still young King.

Alexander the Great is one of the most famous figures from history. Legends and fantastical versions of his life were told almost immediately upon his death, often merging fact with fiction. Through his interaction, both good and mad, with so many different empires and societies, Alexander the Great is viewed through many a lense; hero, villain, demi-god - the list goes on. In this episode, Tristan interviews Dr Peter Toth, the curator of the new British Library Exhibition on Alexander the Great. Together they discuss the idea of an Alexander Romance culture, and the layers of Alexander's mythical past that have helped keep this giant of history alive.
Listen Now

It is also reported that the death of his close friend Hephaestion caused him significant mental anguish, and when Alexander himself died he was planning monuments in his friend’s honour.

But even physically and mentally weakened people usually need an ailment to kill them, and there are theories that he died of a disease. It is possible that he contracted malaria having travelled to the Punjab and back across the Middle East.

A University of Maryland report from 1998 concluded that reports of Alexander’s symptoms match those of typhoid fever, which was common in ancient Babylon.


In his later years Alexander was known to have been increasingly vain, autocratic and unstable. His early reign included a ruthless killing streak as he tried to protect his throne, and it’s likely that he had made many enemies at home.

Despite his many success, his adoption of some Persian practices also made him fall foul of his own followers and countrymen.

Furthermore, Macedonians had somewhat of a tradition for assassinating their leaders – his father, Phillip II, had died at the assassin’s sword as he fled from a wedding feast.

Alleged perpetrators of Alexander’s murder include one of his wives, his generals, the royal cup bearer and even his half-brother. If he was killed by one of them, then poisoning was the weapon of choice – and it was perhaps somewhat masked by a fever.

Tags: Alexander the Great

James Carson