Homicides followed by the suicide of the perpetrator are a rare yet very serious form of interpersonal violence that occurs mainly in partnerships and families. No systematic research on homicide-suicide has ever been conducted in the Netherlands. This study provides an overview of the international homicide-suicide literature. Additionally, this article describes, for the first time, the incidence and patterns of homicide-suicide in the Netherlands and compares these to homicides not followed by suicide. To do so, an existing record containing all homicide cases in the Netherlands in the period 1992-2006 was used. Additional information on homicide-suicide events was retrieved through newspaper analysis. A total of 135 people died in 103 events. Homicide-suicide occurs with an annual incidence of 0.07 to 0.02 per 100,000 persons per year. People who commit homicide-suicide cannot be easily equated to those accused of other types of homicide.