Four examples of family murder followed by suicide are presented with relevant clinical data from the coroners' reports. In retrospect it would appear that three of the offenders were suffering from severe depression, and the fourth showed features of morbid jealousy. In each case there were factors suggestive of mental illness apparent before the tragedy. This is consistent with recent studies of murder followed by suicide and of suicide alone, and raises the possibility that psychiatric intervention may have altered the course of events. Though such tragedies may never be totally eliminated it is considered that close co-operation between coroner, forensic pathologist and psychiatrist may promote greater professional understanding of these tragedies, and provide the impetus for the detection and treatment of potentially remediable psychiatric illness.