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The man had been sitting on the wall before he plunged into the ancient monument's moat, The Guardian reported.
Rescuers forced open a gate on the Via della Palombella to reach him where he was pronounced dead at the scene.
Italian police have opened an investigation, but said no foul play is suspected.
The man was visiting Rome with his daughter, who told investigators he lost his balance after being overcome by a sudden illness, CNN reported.
The wall is frequently crowded with tourists taking a break from sightseeing.
The Pantheon, built under the Roman emperor Hadrian and famed for the oculus in its dome, is one of Italy's most visited attractions.
The ditch where the man was found is open at street level, and police say there have been a handful of similar incidents over the years. Officers regularly patrol the area to prevent people from breaching the perimeter wall.
In March, a 55-year-old Spanish tourist died after falling from a high wall adjacent to the Spanish Steps, another popular Rome landmark.
