Distinguishing between homicides and suicides can be challenging when knots and ligatures are involved. This is particularly true for cases involving decedents who have been bound. If subtle telltales are ignored, foul play may be assumed. In contrast, the discovery of a hanged decedent may lead to a conclusion of suicide. That determination could be premature in the absence of relevant evidence and a thorough analysis of the knots and ligatures. As several authors note, the analysis of equivocal cases must include all collateral evidence, not only the scene evidence but family and decedent history, the overall context, and the death scene circumstances [1-6]. can tying performed by an assailant be distinguished from knots and ligatures tied by decedents on their own bodies? To answer these questions, survey and case data were analyzed and compared to discern any useful differences. These observations were incorporated into a proposed checklist of contrasting characteristics, which will be outlined near the end. 2 | BACKG ROUND AND R ATIONALE In the United Kingdom during the late 1970 s, Underwood investigated an unusual case in which three children were discovered