Upon receiving word from the owl Hamuul Runetotem sent, that the new Warchief sanctioned the killing of innocent druids (actually carried out by orcs loyal to Twilight's Hammer), Cairne issues a Mak'gora, challenging Garrosh for leadership of the Horde. Garrosh accepts, but adds the caveat that the combat would not be the non-lethal combat sanctioned by Thrall, but by the old laws - to the death. Cairne agrees, and the combatants meet in the arena in Orgrimmar
Each combatant is allowed one weapon and no armor. Cairne takes up his Bloodhoof Runespear, a sacred weapon of the Bloodhoof chieftains, while Garrosh carries [Gorehowl], the axe that belonged to his father, Grom Hellscream. The weapons are blessed by shaman; Gorehowl is blessed by Magatha Grimtotem, who seems approving of the new Warchief. At first gaining the upper hand, the Runespear is shattered by Gorehowl and Cairne takes a glancing slash in the chest. Cairne suddenly becomes faint and unable to raise what remained of his Runespear to defend himself, and he realizes that Magatha has poisoned Garrosh's weapon. Cairne's last thought is a lament - that he, who had lived with honor, would die betrayed, just as the howling axe of Hellscream slices into his neck. The tauren leader dies before he even hits the ground.