This study explores 63 homicide–suicide cases that include two or more homicide victims, in the People’s Republic of China. This is the first study to examine homicide–suicide in the Chinese context, following calls to develop a research strategy outside of the USA and Europe. Data are derived from a content analysis of Chinese news sources from 2000 to 2014. Findings show homicide–suicide offenders are likely to be married males living in rural cities who kill their intimate partners and/or children inside a residence using knives. Intimate partner conflict and extramarital affairs are precipitating factors in almost half of the incidents. Patterns of homicide–suicide in China are comparable to those in high-income countries, except that firearms are not the primary means in China and there is no evidence of “mercy killing” among older persons, as described in western homicide–suicide studies. Findings are related to the social and economic structure of Chinese society. Clinical and policy implications include the need for greater transparency and a nationwide homicide and suicide tracking system in China, stricter domestic violence laws, postmortem studies of the brains of homicide–suicide offenders, and psychological autopsies on homicide–suicide perpetrators.