Quality management is an essential component of patient care in all healthcare systems. Historically, the medical autopsy has been considered the gold standard of diagnostic medicine. Discordance rates between autopsy and clinical diagnoses identify opportunities to strengthen patient care and guide healthcare quality improvement strategies. The purpose of this study was to combine a decade of data and analyses of discordance and concordance between autopsy and clinical diagnoses in the Saskatoon Health Region. Within our study, the autopsy rate of all in-patient deaths was approximately 6%. Among the 441 cases included in the study, 79 were discordant (17.9%), 342 were concordant (77.6%), and 20 were inconclusive (4.5%). The discordance rate ranged from 9.7% in 2007 to 26.3% in 2011. Hospital autopsies continue to contribute to clinical knowledge and patient care and should therefore be utilized to their fullest potential in healthcare quality improvement.