Intimate partner homicide-suicide (IPH-IPS) among women during the childbearing years leaves irreversible outcomes that are devastating and have lasting repercussions for surviving children, families, and communities. An estimated one-third of all intimate partner homicides of women aged 15 to 50 end in suicide. The purpose of this study was to describe the temporal trends and characteristics of both victims of IPH-IPS. Data were collected using a retrospective, cross-sectional analysis of medical examiner records for women aged 10 to 50 in Maryland, during 1994-2003. Seventy-five IPH-IPS incidents were identified over the 10-year period. Of those, 94.7% were a female homicide followed by a male suicide. The average rate of IPH-IPS was 0.52 per 100,000 women aged 10 to 50. About half of the couples were within 5 years of the age of each other, married or separated and the same race. Eleven percent of the women were pregnant/1-year postpartum when they died. The findings presented represent a significant public health problem that has a unique pattern compared with other populations studied. Understanding this problem involves a more comprehensive assessment of both victims. There is a need for a national surveillance system that identifies IPH-IPS events and provides information on both victims that includes individual and relationship characteristics.