Adolescents or children who murder usually do so within the family but may also act violently toward strangers; however, the psychodynamics and family dynamics differ among groups. Children who kill often are acting out the fantasies, wishes, or unconscious urges of their parents and very often have disturbed family relationships. But not all adolescent killers are the same and may not all be treated similarly. Some suffer from brain damage, other from schizophrenia, others from psychoneurotic tension, and still others appear to have either a normal personalilty or a character and personality disorder that became aggravated under the impact of familial and environmental pressure. Treatment for such offenders should begin with a thorough physical examination along with a complete family and individual psychiatric assessment. Once the factors involved in the specific offense are known, then adequate treatment may be instituted. This may involve medication, confinement, hospitalization, psychotherapy, family therapy, educational and occupational rehabilitation, or separation from the tension of the family environment. Based on the factors research has identified as being characteristic of children at high-risk of homicidal behavior, prevention and early intervention can be undertaken, Prevention may include adequate medical care, family therapy, or separation of the child from the family. Twenty-five references are listed.