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A preliminary autopsy report revealed that U.S. Republican Sen. Lindsey Graham died from an aortic dissection linked to atherosclerotic cardiovascular disease. The 71-year-old senator passed away Saturday night following a brief illness.
Graham’s office said the South Carolina senator died from a cardiovascular condition linked to hardening of the arteries.
According to a preliminary review by the Washington, D.C., Office of the Chief Medical Examiner, Graham’s cause of death was recorded as an aortic dissection caused by atherosclerotic cardiovascular disease.
U.S. President Donald Trump told Reuters he had spoken with Graham “minutes before” he became ill and said there was nothing suspicious about his death.
“There are rumors to that effect, but no,” Trump said. “He had a brief illness. He had a heart attack. He was my friend, a very close friend. Losing him is devastating.”
Trump also ordered U.S. flags to be lowered to half-staff in Graham’s memory until Saturday night, July 18.
Graham’s death is not expected to directly change the fight for Senate control in the November midterm elections, but it has affected Republicans’ position in Congress.
With Kentucky Sen. Mitch McConnell still hospitalized after a fall, Republicans’ effective Senate majority temporarily fell to 51 seats after Graham’s death.
The Senate was set to resume work Monday after the July 4 holiday. Republicans were aiming to advance defense and national security bills and confirm Trump’s former lawyer Todd Blanche as attorney general.
Under South Carolina law, Republican Gov. Henry McMaster can appoint someone to temporarily fill Graham’s seat until the term expires in January.
A special Republican primary for the seat will be held Aug. 11. If no candidate wins an outright majority, a runoff will take place Aug. 25.
The Republican candidate will face Democrat Annie Andrews in the November general election.
Graham was known for his hawkish stance on defense policy and was one of the strongest supporters of Ukraine and Israel, while also being one of the sharpest critics of Iran.
Ukrainian President Volodymyr Zelenskyy said in a social media post that he was deeply saddened by Graham’s death and described him as “a true defender of freedom and the values that make the world safer.”
Graham met Zelenskyy in Kyiv one day before his death. They discussed Ukraine’s air defense needs and a new sanctions bill targeting Russia.
U.S. Rep. Michael McCaul said Graham’s death could add momentum to passing the sanctions bill Graham had led against Russia.
“The best way to honor Lindsey is to pass his bill,” McCaul said.
Israeli Prime Minister Benjamin Netanyahu said in a message that Israel had lost one of its greatest supporters.
“Israel has lost one of its greatest supporters. I have lost a dear friend,” Netanyahu said.
A senior Israeli official said Netanyahu is expected to attend Graham’s funeral.
In the weeks before his death, Graham had been working on a new push to normalize relations between Saudi Arabia and Israel, according to an account based on multiple conversations with the senator.
Graham viewed Saudi-Israel normalization as the defining prize of a broader post-war settlement in the Middle East, one that could outlast the military campaign against Iran and reshape the region.
He had worked on the issue for years, including with the Biden administration, and believed the opening created by Iran’s weakening could give Trump a rare chance to broker an agreement.
Graham planned to begin an intensive diplomatic effort after Israel’s October elections and the U.S. midterms, to reach a deal before the new Congress was sworn in in January.
But Graham believed the war with Iran first had to be brought under control, especially the ongoing crisis in the Strait of Hormuz.
He had urged Trump to authorize a short and overwhelming military operation to reopen the strait if diplomacy failed.
Graham was one of the key figures outside the administration whom Trump consulted on foreign policy and national security, especially on the Iran war.
He helped lead a group of hawkish advisers who backed the U.S. campaign and urged Trump to intensify military pressure on Tehran.
In mid-May, Graham began urging Trump to make Saudi-Israel normalization the centerpiece of a broader regional “day-after” plan for the war.
A week later, Trump told leaders of several Arab and Muslim countries during a conference call that he wanted them to establish relations with Israel if an agreement could be reached to end the war with Iran. His primary focus was Saudi Arabia.
Saudi Crown Prince Mohammed bin Salman had previously shown a willingness to normalize relations with Israel, though his enthusiasm had cooled over the past year.
Saudi officials continued to insist that any deal must include an irreversible, time-bound path toward the creation of a Palestinian state.
Netanyahu’s far-right government rejected that condition, and it remains unclear whether Israel’s political landscape after the October election will create room for such a move.
Graham said in recent weeks that he had discussed the initiative with Trump, as well as U.S. envoys Jared Kushner and Steve Witkoff, and that they had agreed to pursue it in a coordinated way.
He also said he had spoken with Netanyahu confidant Ron Dermer, Saudi Ambassador to Washington Princess Reema bint Bandar and Saudi Foreign Minister Prince Faisal bin Farhan.
Graham had been planning a trip to Saudi Arabia and Israel in the coming weeks to assess whether there was appetite for reopening talks.
He said that if there was an opening, he wanted intensive work to begin in September so the pieces of a deal could be in place by November.
Graham believed the effort faced two linked political challenges: securing enough votes in Congress and producing an Israeli government willing to meet Saudi Arabia’s conditions.
A central element of the proposed agreement was a U.S.-Saudi defense treaty whose text had largely been negotiated during the Biden administration.
Such a treaty would require support from two-thirds of the Senate. Graham believed the lame-duck session after the November midterms offered the only realistic window for ratification.
Winning enough Democratic votes would require the deal to include meaningful progress on the Palestinian issue, including an Israeli commitment to a future Palestinian state and concrete steps toward that goal.
That created a parallel challenge in Israel: ensuring that the government formed after the October election was willing and politically capable of making those commitments.
Graham said he intended to work with Trump and his team to make clear to Netanyahu and other Israeli leaders that Washington expected the next government to move in that direction and to press it hard to do so.
Graham spoke with Trump by phone Saturday night and briefed him on his recent trip to Ukraine and the Russia sanctions bill he wanted the Senate to vote on soon.
Trump told Graham he was preparing to launch fresh strikes against Iran after another attack on commercial ships in the Strait of Hormuz.
A person who spoke with Graham shortly afterward said the senator complained that he was feeling unwell. When the person urged him to seek medical attention immediately, Graham said he would do so Sunday morning after his scheduled appearance on NBC’s “Meet the Press.”
Graham then joked: “I can’t die now. I still need to do the Russia sanctions, get Iran sorted out and do Israeli-Saudi normalization.”
He died several hours later.
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