Rampage school shootings, where students go to their own school to randomly kill classmates, teachers, friends, and strangers, are among the most drastic types of human behavior. While research increasingly points to interaction dynamics as being key for the emergence of crime and violence, scholars have not yet systematically studied interaction dynamics in school shootings. Further, existing research usually focuses on a handful of cases where many victims were killed and overlook rampages with no or few fatalities. To fill these gaps, my study analyzes interaction dynamics in a full sample of US rampage school shootings. It triangulates novel types of data in a mixed methods approach that combines in‐depth qualitative analyses, cross‐case comparisons, and descriptive statistics. Findings highlight that specific interactional patterns to rampages exist that correlate to whether shootings end in mass killings. Shooters systematically use interactional pathways in which they avoid facing victims. They further show that most shooters are bad at killing, despite motivation and planning. Findings have implications for our understanding of violence and school safety, as well as the role of situational interaction in leading to social outcomes more broadly. Please see video abstract at: https://youtu.be/H7xHMQd5RT0.