The most significant risk factor for intimate partner femicide-suicide was prior domestic violence against the victim. Two other risk factors emerged as unique to femicide-suicide cases compared to femicide-only cases: (1) prior suicide threats made by the perpetrator, and (2) victim having ever been married to the perpetrator. The femicide-suicide cases were more likely to involve married, employed couples who reported less illicit drug use and abuse during pregnancy. Policy implications are discussed and include the observation that the access and use of guns significantly increased the risk of death for both the victims and their abusive partners in the current study. Research methodology involved a case control study across 11 States where 310 consecutive femicide cases from 1994 through 2000 were identified through police and medical examiner records; 67 of these cases were femicide-suicide cases. A control group of 356 physically abused women were recruited via random digital dialing within the same cities. Detailed questionnaires assessed perpetrator, victim, relationship, and incident characteristics. Statistical analysis techniques included bivariate analyses and logistic regression. Future research should explore cases in which other family members are killed, such as children, which occurred in 40 of the 310 cases examined in this study. Figure, tables, references