Illness and death
In January 1867, the Emperor was diagnosed with smallpox, which caused surprise because Kōmei had allegedly never been ill before. On 30 January 1867, he suffered a fatal violent bout of vomiting and diarrhea, and had purple spots on his face. Emperor Kōmei's death was distinctly convenient for the anti-bakufu forces whom Kōmei had consistently opposed. It was rumored at the time that he was assassinated either by radicals from Choshu, or radical officials in the court. British diplomat Sir Ernest Satow wrote, "it is impossible to deny that [the Emperor Kōmei's] disappearance from the political scene, leaving as his successor a boy of fifteen or sixteen [actually fourteen], was most opportune". However, there is no evidence of this and it is generally believed that he was simply one more victim of what was a worldwide pandemic at the time. Nevertheless, by the time of Emperor Kōmei's death the government was faced with bankruptcy and near collapse. Japan was also surrounded by colonial powers, who stood poised to gain considerable influence with substantial investments in Japanese trade. Kōmei's son, Imperial Prince Mutsuhito, was crowned as Emperor Meiji on 12 September 1868 and these issues were put to rest under the Meiji Restoration.
After Kōmei's death in 1867, his kami was enshrined in the Imperial mausoleum, Nochi no Tsukinowa no Higashi no misasagi (後月輪東山陵), which is at Sennyū-ji in Higashiyama-ku, Kyoto. Also enshrined in this mausoleum complex are Kōmei's immediate predecessors since Emperor Go-Mizunoo: Meishō, Go-Kōmyō, Go-Sai, Reigen, Higashiyama, Nakamikado, Sakuramachi, Momozono, Go-Sakuramachi, Go-Momozono, Kōkaku and Ninkō. Empress Dowager Eishō is also entombed at this Imperial mausoleum complex.
Emperor Kōmei was the last Emperor to be given a posthumous name chosen after his death. Beginning with the reign of his son, Emperor Meiji, posthumous names were chosen in advance, being the same as their reign names.