AimTo analyze the clinical and unconscious stakes of uxoricide and to suggest reflections for the therapy of these patients, and for the therapy of perpetrators of domestic violence, which could perhaps reduce the risk of uxoricide. MethodA literature review from an integrative perspective, based on frames of reference referring respectively to psychiatry, psychoanalysis, and attachment theory; an analysis of case studies, based on clinical interviews with uxoricide perpetrators. ResultsThe perpetrators of uxoricide (an acting out occurring outside of a context of psychotic, paranoid decompensation, or any other decompensation making the author irresponsible for his acts) present a borderline personality structure, seeking, after their action, to defend themselves against the threat of narcissistic collapse, while their amnesia only aims to maintain them in a kind of protective denial, preventing them from recognizing how much their partner has, unwittingly, allowed them to express their tendency to dependence in an essentially anaclitic type of relationship. The uxoricide can also be linked to an absolute quest for the object that could compensate for any lack. DiscussionAll the data collected suggest the value of taking into account the dynamic intrapsychic dimensions during treatment and, in the context of more quantitative clinical research, the comparison of a group of perpetrators of uxoricide and a group of subjects who perpetrate violence without uxoricide. ConclusionThe common characteristics of the perpetrators of uxoricide are a separation anxiety disorder, an insecure attachment style, a fragile narcissistic foundation, and an objectification of the partner. In a therapeutic context, understanding more of these pathological narcissistic states seems important to our efforts to help these patients avoid repeat offending or suicide. Perpetrators appear as victims of an impossible mourning.