Investigations of lethal violence in the United States have primarily focused on Whites and/or African-Americans, generally ignoring American Indians. Interestingly, statistics indicate that homicide and suicide rates among American Indians are often higher than other racial/ethnic groups within the United States. In an attempt to understand these lethal violence patterns, the current study utilizes the integrated model of suicide and homicide to investigate the structural and cultural factors that contribute to the production and/or direction of American Indian lethal violence. Using data from the Indian Health Service, Centers for Disease Control and Prevention, and the U.S. Census Bureau, a modified lethal violence count (LVC) is used to examine the production of lethal violence among American Indians within U.S. counties as well as the suicidehomicide ratio (SHR) to unravel the etiological underpinnings of lethal violence. Findings indicate partial support for the integrated model with economic conditions and family disruption influencing these patterns of lethal violence. Figure, tables, notes, and references (Published Abstract)