Results found that a total of 103 homicide-suicides occurred in the Netherlands between 1992 and 2006. The Dutch rate is comparable to rates found in the same period in other European regions such as England, Yorkshire, and Humbershire. However, the Dutch rate seems to be much lower than current rates in other parts of the Western hemisphere. This might be the result of the relatively small sample size of studies finding a high proportion of homicides ending in the suicide of the perpetrator, or it might be the result of lenient gun legislation and more readily available firearms in regions where the proportion of homicide-suicides is high. Although the homicide rate in the Netherlands is considerably lower than in other countries such as the United States, the homicide-suicide rate is also lower than in the United States. Homicide-suicides more closely resemble domestic homicide statistics instead of national homicide figures. Whereas there was a sharp decline in the number of Dutch homicides in 2006, the number of domestic homicides occurring per year has remained constant. Homicide-suicide rates are subject to similar influences and are of comparable stability as the rate of domestic homicide. On an epidemiological level, homicide-suicide more closely resembles homicide than suicide. Data were collected using the newly established Homicide-Suicide 1992-2006 database and newspaper articles. Tables, figures, notes, and references