Homicide has remained the third leading cause of death among girls aged 10 to 19 for more than a decade. In addition, despite the 13 percent drop in adolescent pregnancy, adolescent pregnancy in the United States remains a significant problem. The connection comes in the compelling findings identifying homicide as a leading cause of non-obstetric deaths in pregnancy and the postpartum period, leading to an evaluation of the relationship between homicide and pregnancy in teens/adolescents that died a suspicious death in Maryland. This study used a retrospective cohort design to select records for all women aged 10 to 50 during the period 1994 through 1998, who were referred to the Maryland Office of the Chief Medical Examiner (OCME) for evaluation. Only women who received a full autopsy or who had evidence of pregnancy documented were included in the final analysis. The findings indicate that teens aged 10 to 19 had an increased likelihood of being homicide victims compared to their adult counterparts. When the teen was pregnant, the magnitude of the relationship doubled. In addition, an unusual finding in the study was the relationship between the use of drugs and alcohol and homicide as a cause of death. Teens were more likely to die due to homicide if they did not have positive toxicology findings at autopsy. The findings highlight the risks of adolescence, raising many questions. The findings are consistent with previous research indicating an increased risk for violent death among pregnant and postpartum teens. Tables and references