There is currently a lack of information regarding the prevalence of and characteristics associated with blunt force trauma related homicides in South Africa. Information relating to the patterns of blunt force trauma could assist in the development and implementation of interventions targeted at specific areas or individuals as well as direct future research towards areas in need of investigation. This study is a 5-year retrospective review of autopsy reports obtained from Salt River Mortuary (Cape Town, South Africa). The prevalence of blunt force trauma was considered for unnatural deaths with a focus on homicide. The patterns of homicidal blunt force trauma are also presented. A total of 15 519 autopsy cases was analysed. In 1198 (7.72%) of these cases, the cause of death was found to be blunt force trauma and 828 (5.32%) of these cases were classified as homicides. Approximately 11% of blunt force homicide cases occurred in combination with sharp and/or ballistic trauma. Men from poor socio-economic areas were shown to be most at risk of blunt force homicide in the City of Cape Town.