One hotly debated topic within the field of intimate partner violence (IPV) is the degree to which IPV can be understood as primarily a unidirectional versus bidirectional phenomena; this topic forms a key component of the gender symmetry versus asymmetry of domestic violence debate. Resolution of this controversy has important prevention and intervention implications. In the current study, a comprehensive review of the literature was conducted, and 48 studies that reported rates of bidirectional versus unidirectional physical violence (male-to-female and female-to-male) were uncovered using a variety of search engines and key terms; one relevant meta-analysis and one seminal book chapter were also identified. Included empirical studies were published in 1990 or later, appeared in peer-reviewed journals, and contained empirical data directly related to bidirectionality of violence. Studies that only reported correlations between self-reported perpetration and victimization were excluded from these analyses. Qualifying studies were then categorized by the nature of the sample they assessed (i.e., large population samples; smaller community; purposive or convenience samples; clinical or treatment-seeking samples; legal/criminal justice-related samples; and samples assessing the relationships of gay, lesbian, and/or bisexual individuals). Rates of bidirectional versus unidirectional violence (male-toward-female vs. female-toward-male) were summarized directly as reported or were derived on the basis of data contained within the article.All obtained studies (48 empirical, 1 meta-analysis, 1 book chapter) were then entered into an online summary table for public review; however, additional results were specifically calculated for the current article. These results indicate that bidirectional violence was common across all types of samples (population-based to criminal justice). This suggests that the role of women in violent relationships is important to consider, even if all aspects of women’s perpetration of IPV are not symmetrical to men’s perpetration of IPV. A second finding to emerge was that the ratio of unidirectional female-to-male compared to male-to-female IPV differed significantly among samples with higher rates of female-perpetrated unidirectional violence found in four of the five sample types considered. Higher ratios of male-to-female unidirectional violence were found only in criminal justice/legal studies that relied on police reports of IPV perpetration and/or in samples drawn from the U.S. military. Competing explanations for the differing ratios were offered in the current discussion. These need to be tested empirically in order to fully understand the expression of IPV across samples and settings. Differences in the directionality of the expression of IPV were not found in samples of gay, lesbian, or bisexual individuals; however, rates of bidirectional violence appear to vary by race/ethnicity with higher rates of bidirectional violence among Black couples. Overall, it is suggested that if one resolution of the gender symmetry/asymmetry debate is to argue that there are subtypes of male and female domestic violence perpetrators (Johnson, 2005; Johnson, 2006), or that there are different patterns of violence among different types of relationships characterized by IPV (Stets & Straus, 1989), researchers and clinicians will need to work together to determine how to reliably and meaningfully make these determinations in ways that will facilitate our ability to effectively prevent and treat all types of IPV.