Statistics on age, sex, social status, and ethnicity of those who commit homicide-suicide are summarized. The article presents two classifications, one based on psychopathology and one on the nature of the relationship between perpetrators of homicide-suicide and their homicidal victim, i.e., consortial homicide-suicide, physically ailing consort subtype, adversarial homicide-suicide, filial homicide-suicide, and cult homicide-suicides. The review suggests a three-dimensional analytical approach to understanding this criminal phenomenon: psychopathology and ego deficits of the perpetrator, cumulative and precipitating factors, and motivation and vector of destructive urges against self and the other victim. 12 tables and 40 references