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Using data from the National Violent Death Reporting System, we address the role that intimacy plays on the level of violence exhibited in homicide-suicides that occurred between 2004 and 2011. The purpose is to determine whether the relationship between a homicide victim and their perpetrator is related to the severity of injuries inflicted on the victim during a homicide-suicide incident. Results indicate that severity of victim injuries can be explained as a function of the relational distance between the victim and offender, other demographic characteristics, and whether intimate partner violence was present in the relationship.