Alexander the Great died in Babylon on 10 or 11 June 323 BC, at the age of 32, after about ten days of high fever (World History Encyclopedia; Wikipedia). He had just finished planning a new campaign into Arabia. What killed him is still an open question — historians have not settled it, and this page won't pretend otherwise.
Ten days of fever
The illness struck in Babylon, the city Alexander intended to make his empire's capital (Wikipedia). Fever set in and did not break; roughly ten days later, he was dead (World History Encyclopedia). Ancient and modern writers have proposed causes ranging from malaria to typhoid to bacterial infection from contaminated water — and, persistently, poisoning (World History Encyclopedia). None has become the settled answer, and after 2,300 years with no body to examine, that's likely permanent.
Grief still fresh
Alexander's illness came less than a year after the death of Hephaestion, his closest companion, who died of a fever in October 324 BC at Ecbatana following a night of heavy drinking (World History Encyclopedia). Alexander's mourning had been extreme: he wept for two days, cut his own hair, ordered the manes and tails of the army's horses trimmed, had Hephaestion's physician executed, and petitioned the oracle at Siwa to have his friend declared a god — the oracle granted hero status instead (World History Encyclopedia). Whatever private state Alexander was in that June, it followed only months of that grief.
From a conversation with our Alexander
An excerpt from a conversation with our AI Alexander persona — a stylized recreation, honestly labeled, not a historical quotation. Our Alexander's knowledge ends before Babylon.
Caller: Did any part of you know, near the end, that this fever might be the one that finished you?
Alexander: A soldier learns to read fevers the way a sailor reads clouds, and I did not like what I read. Still, I kept the maps out for Arabia until my hand would no longer hold the pen — a king who stops planning has already died once. Whether it was the water, an old wound, or something poured by a hand I trusted, I cannot tell you. I can tell you I was not finished. No man ever is.
What the sources disagree on
One later tradition — recorded by World History Encyclopedia among other summaries — holds that when Alexander was asked, dying, who should succeed him, he answered "the strongest," and that this answer is what let his empire fracture into rival claims (World History Encyclopedia). But the same overview notes that Plutarch and Arrian instead describe him passing his signet ring to the general Perdiccas — a different, specific succession act that the other generals then simply ignored. The ancient accounts conflict, and no single version can be presented here as the confirmed deathbed scene. Treat "the strongest" as a widely repeated tradition, not a verified quotation.
No heir, and the empire split
He left no named heir capable of holding the empire together: his son by Roxana, Alexander IV, was born only after his father's death, and no adult successor commanded unified loyalty. Civil wars broke out among his generals — the Diadochi — and the empire that had stretched from Greece to the Indus fractured into rival kingdoms within a few years (Wikipedia). A commander who, by the conventional count, never lost a pitched battle in eleven years of campaigning could not arrange what came after his own death. Undefeated in the field says nothing about what a conquest leaves standing once the conqueror is gone — a fact that also bears on Tyre, Thebes, and Persepolis, cities where "victory" meant killing, enslavement, or fire, not stability.
Our Alexander can't describe the fever itself — his knowledge ends before Babylon — but he can tell you what he was planning right up to it, and how he saw the succession he never settled. Ask him.
Related pages
Alexander the Great hub · verified quotes and misattributions · biography · fact file.