Filicide, the murder of a child by its parents, is sometimes accompanied by suicide of the perpetrator. Few studies have examined the differences between suicidal and non-suicidal filicides, as data sources often lack detailed information regarding psychiatric factors as well as the motives underlying the offence. This descriptive, exploratory study overcomes this limitation by studying filicide-parasuicides: filicides followed by the failed suicide of the perpetrator. The purpose of this study was to identify motives, mental health characteristics and other factors associated with filicide as a function of the presence or absence of parasuicide. In total, 128 filicide cases were retrieved from a forensic mental health hospital in the Netherlands, 30 of which ended in a severe act of parasuicide by the perpetrator. The results suggest that filicide-parasuicide constitutes a different category of lethal violence against children. This group includes parents who take their child along in their suicidal ideations as well as parents who kill their children to retaliate against their intimate partner. The majority of suicidal parents were generally not abusive towards their children. These findings suggest that conventional prevention measures in the area of domestic violence might not be applicable to the group of suicidal parents killing their children. Instead, practitioners should be aware of parental over-identification, especially when combined with suicidal ideation in the parent. Other areas in which preventative measures can be taken include cases of disputed child custody.