The connection between the victim–offender relationship and injury patterns has been established in the lethal violence literature; however, this association has not been explored in the study of homicide followed by the perpetrator’s suicide. Using data from the National Violent Death Reporting System (NVDRS), we address this research gap by examining violence inflicted on 1,718 homicide–suicide victims that occurred between 2003 and 2013. Results show some support for variation in injury across intimacy and relationship status while considering victim and offender characteristics; however, results were not as predicted. Avenues for future research are discussed.