Herod the Great is generally understood to have died in 4 BCE in Jericho after a prolonged, extremely painful illness, most likely from natural causes involving severe chronic disease rather than sudden violence or execution. Ancient and modern medical analyses suggest a mix of chronic kidney disease and severe genital infection as the leading explanation for his death.

Core historical account

Most information about how Herod died comes from the Jewish historian Josephus, who describes Herod’s final illness as excruciating, with putrefying symptoms and intense pain. Josephus places Herod’s death in Jericho, after a period of physical and mental disorder marked by paranoia, family executions, and repeated changes to his will.

Key points from the ancient sources:

  • Location: Jericho, in his winter palace.
  • Time: Around 4 BCE, near the end of his roughly 37–4 BCE reign.
  • Nature: A drawn‑out, agonizing disease rather than a single traumatic event.

Medical theories on Herod’s death

Modern doctors and historians have tried to retro‑diagnose Herod’s illness using Josephus’s symptom list. Commonly cited symptoms (from Josephus, as summarized by modern scholars):

  • Severe itching and skin problems
  • Intestinal and respiratory trouble
  • Extreme abdominal pain and convulsions
  • “Gangrene of the genitalia,” with descriptions of worms and putrefaction

Major modern theories include:

  1. Chronic kidney disease plus Fournier’s gangrene
    • One influential analysis argues Herod suffered long‑standing kidney failure, which would explain edema, shortness of breath, and systemic decline.
 * The horrifying genital symptoms match a condition called Fournier’s gangrene, a rapidly spreading infection of the genital region that can be fatal.
  1. Parasitic disease leading to renal failure
    • Another medical paper proposes infection with Schistosoma haematobium , a parasite that can damage the urinary tract and kidneys and produce fistulas and genital destruction, matching reports of “worms” and gangrenous genitalia.
  1. Arteriosclerosis and general breakdown
    • A more conservative view, such as that noted in some modern encyclopedias, is that Herod died of natural causes with significant arteriosclerosis, compounded by other chronic conditions in old age.

Suicide attempt and mental state

Josephus also reports that during his final illness, Herod’s suffering and paranoia drove him to attempt suicide by stabbing himself, but the attempt was thwarted by a relative. This suggests:

  • He did not die by suicide according to Josephus, though the attempt reflects desperation and severe psychological distress.
  • His mental decline showed up in extreme cruelty and repeated purges, including the killing of his own sons, shortly before his death.

“Eaten by worms” and later stories

Over time, Herod’s gruesome end was described in increasingly vivid, moralizing terms.

  • Josephus’s language about putrefaction and possible worms in the diseased tissue likely reflects real infection and necrosis rather than a purely symbolic image.
  • Later popular and documentary treatments emphasize the “eaten by worms” angle, turning his death into a cautionary picture of a tyrant receiving a horrific end, though this builds on and dramatizes the medical realities described by ancient sources.

Bottom line

Putting the evidence together:

  • Herod the Great died in 4 BCE in Jericho after a prolonged, agonizing illness, not by execution or battle.
  • The most widely accepted modern view is that he suffered from chronic kidney disease complicated by severe genital infection (likely Fournier’s gangrene or a similar process), producing gangrene, worms, and systemic collapse that finally killed him.

Information gathered from public forums or data available on the internet and portrayed here.