The case of Aileen Wuornos, executed in Florida for the serial killing of seven men, is studied to determine her degree of psychopathy and the presence or absence of sexuality or sexual sadism as a motivation or gratification for her crimes. The authors, one of whom evaluated the subject shortly before her death, determined that she evidenced a psychopathic personality (PCL-R score 32). She also met DSM-IV-TR criteria for Antisocial Personality Disorder and Borderline Personality Disorder. While her killings ostensibly were carried out during routine acts of prostitution, there was ambiguous evidence that her crimes were sexually motivated or gratifying. Her articulated motivation was robbery and elimination of the witness/victim. After carefully considering all available data, the authors concluded there was no convincing evidence of sexual sadism in either her personal history or her method of committing serial murder, and it remains unclear whether sexual gratification was to some degree a motivating factor in her commission of these offenses. The confluence of early childhood attachment disruptions, severe psychopathy, other personality disorder pathology, and a traumagenic abuse history likely contributed to her having serially murdered seven victims.