Sharp-force homicide-suicide in an intimate partner relationship: a case from Nepal with possible ritualistic elements

Abstract Background Homicide followed by suicide (HS), often known as dyadic death, is a rare but tragic phenomenon that usually occurs in intimate partner or family relationships. Although these cases are frequently reported in the literature on forensic medicine around the world, they are rarely reported in Nepal. Case presentation We report a case from rural Nepal where a man in his mid-30s killed his wife, also in her mid-30s, with a sharp weapon and then committed suicide by cut-throat injury. There was a suicide note and ritualistic activity. Characteristic injuries consistent with the chronology of events were found during the medico-legal autopsy. Conclusions This case illustrates the intersection of interpersonal conflict, superstition, and possible undiagnosed psychiatric conditions, thereby contributing to the limited South Asian literature on HS. This case highlights the potential value of early psychiatric risk identification and culturally informed outreach, though broader policy conclusions cannot be drawn from a single case.