The assessment of individuals charged with a sexual offence has evolved over many years and has become more specialized. The most comprehensive evaluation is available in specialized centres for assessing and treating sexual deviations. Sexually motivated homicide is an extremely rare event. Empirical studies have provided evidence-based characteristics of those who commit sexual homicide and the nature of sexual homicide offences, particularly in the last 10 years. This has assisted in defining whether a sexually motivated homicide has occurred. It can also be incorporated into sexual behaviour evaluations when factors associated with a sexually motivated homicide may be recognized before the person acts out violently. This paper reviews evidence-based research on sexual homicides and how this is used to classify whether a homicide is sexually motivated. Risk factors associated with sexually motivated homicides are reviewed.