Intimate partner homicide-suicide (IPHS) represents the most severe form of domestic violence, and often results in multiple fatalities. This paper examines outcomes of children in households that experience IPHS. Reports of 325 IPHS cases among adults age 18-44 in the U.S. between 1999 and 2004 were collected and examined. Results indicate children were often fatally wounded, but were most likely to witness the event then be absent or killed. Difficult financial conditions during times of economic downturn may increase the possibility of stress-related suicide, and subsequent familicide. Children with a suicidal parent are at increased risk of harm, so identification is of vital importance. Children are most likely harmed or killed by a primarily suicidal male perpetrator, who is usually their biological father. Firearms were used more than other methods in IPHS events. Even those perpetrators with protective orders more often utilized a firearm, which reflected a weakness in Violence Against Women Act gun ban enforcement. In this research, regions of the U.S. with less stringent firearm regulations were disproportionately likely to contain IPHS events. Findings illustrate the importance of making distinctions among perpetrators of IPHS, and assessing firearms policies, in order to improve child death prevention efforts. (Published Abstract)