A 29-year-old Korean man reported to have been robbed, bound, and gagged by a stranger in his apartment. Clinical findings included extensive petechiae to his face and tramline patterned abrasions and ligature furrows to his neck and face, as well as his wrists. This case demonstrates that petechiae due to neck compression also can occur in the living and are due to vascular compression and not lethal hypoxia. Initially, no other leads existed in the investigation, and the police assumed a robbery had occurred; however, the man eventually confessed to fabricating the story and to having self-induced the ligature marks by subluxating his jaw at the temporomandibular joint and hooking the rope closest to the back of his neck on the corner of a table. According to the man’s statement, he had first wrapped a rope multiple times around his head and through his mouth. He tied a knot at the back of his head, thus gagging himself. He then tied a loop with the second rope. Placing his arms behind his back, he inserted his left hand through the loop multiple times until the rope was sufficiently taut. He reported purposefully “dislocating” his jaw, and with the aid of a corner of a table was able to slide the rope down to his neck. His stated motive for his behavior was to experience punishment for “losing face” after his ex-girlfriend terminated her pregnancy. 6 figures and 16 references