Sexual homicide is a heavily studied, but unclearly defined, area of homicide studies. This article examines the empirical studies in sexual homicide from the mid-1980s to 2008. A review of the literature focuses on definitions, general theoretical understanding, and typologies that have evolved over the years. Issues surrounding the study of sexual murderers, such as sadistic fantasy and developmental deficits, are addressed. A comparison of different types of sexual homicides through a synthesis of 32 published empirical studies is made. The article concludes with an analysis of these studies and discusses implications for practice, policy, and research.