Understanding the motives behind femicides is crucial to design effective prevention strategies and to support women's self-determination, free from threats to their mental and physical integrity. We conducted a retrospective, multicenter forensic study involving 27 Italian Institutes of Legal Medicine, analyzing 1238 female homicides (1950–2023). Cases were classified as femicide or non-femicide female homicide according to the medico-legal definition of femicide as the murder due to the failure to recognize women's right to self-determination. Motives were categorized into 12 groups, and relevant anamnestic and circumstantial data were collected. Of the 1238 cases, 410 were identified as femicides, 395 as non-femicides, and 433 were excluded for insufficient information. Femicides were most frequently driven by jealousy/rejection (n = 185; 45.1 %) and separation/divorce (n = 144; 35.1 %), often in the context of intimate partner violence or inability to accept the end of a relationship. Non-femicides were predominantly associated with the perpetrator's psychiatric disorder and/or drug addiction (n = 126; 31.9 %), violent aggression without gender-related motive (n = 69; 17.5 %), victim's illness (n = 63; 15.9 %), or economic reasons (n = 58; 14.7 %). In the Italian context, most femicides stem from relational dynamics − particularly jealousy, rejection, and separation − whereas non-femicides are more often linked to psychiatric illness, substance abuse, or non-gender-related aggression. Incorporating these findings into clinical risk assessment protocols, especially in emergency and primary care settings, may help identify women at high risk and guide targeted prevention strategies.
