This communication provides a perspective of long term trends in homicide & suicide in Cuyahoga County. Comparable metropolitan areas in the United States have had similar recent experience. Many important facets of homicide & suicide are untouched by this general survey, & the authors recognize a need for future work to focus in greater detail on such variables as the role of alcohol & drugs, age, relationship of victim & assailant, socioeconomic factors, & the legal followup of the homicide.