The Mediterranean monk seal (Monachus monachus) is one of the world's most endangered marine mammals. The largest population is located mainly throughout the Aegean and Ionian islands and along the coastline of southern continental Greece. We report the findings of a necropsy and discuss their potential importance to the conservation of the species. The adult female monk seal appeared to be in a good nutritional state. The main necropsy findings were injuries consistent with a violent and sudden death, including three round wounds on the ventral surface of the body and several hematomas, as well as a decomposing male fetus in the uterus. Two nematodes were found in the right ventricle of the heart; no abnormalities were observed in the lungs, pulmonary vessels, or heart. The nematodes were identified as Acanthocheilonema spirocauda. This is the first report of infection of the Mediterranean monk seal with A. spirocauda, even though this is the most common heartworm found in most pinnipeds worldwide. This parasite should be considered in health care monitoring projects of this endangered species.