The literature shows that "sexual homicide" has proven difficult to define. Although researchers have consistently concluded that sexuality and aggression should be linked in such cases, the nature of that link has not gained a consensus across studies. No matter how "sexual homicide" is defined, apparently each case has distinctive characteristics. Regarding the profiles of perpetrators of sexual homicide, findings across studies have been consistent in identifying two main types of offenders who kill victims in association with some type of sexual assault: those primarily motivated by anger or revenge and those motivated by a sadistic sexual drive. There is accumulating evidence to support the view that anger and sadism are important concepts in the motivation for extreme acts of sexual violence; each pathway to sexual homicide apparently has a distinctive set of risk-related and clinically related factors that must be identified when planning offender treatment. The literature is consist in concluding that the majority of sexual murderers, even those detained in forensic psychiatric hospitals, do not suffer from a major mental illness. Personality disorders are more common. There is mixed opinion, however, about the nature of that pathology. Psychopathic traits, paraphilic, and paraphilia-related disorders are also common and should be assessed during treatment development. The current state of the research literature indicates that traditional sex offender treatment packages, such as the Sex Offender Treatment Program in the United Kingdom, are suitable for the treatment needs of sexual murderers. Social isolation and having an over-controlled temper seem more prevalent in sexual murders than other sex offenders and may require further clinical attention. 1 table and 96 references