Intentional simulation and dissimulation of criminal acts are behaviour patterns frequently met in both police investigations and forensic medicine. Even more worrying are homicide cases disguised as suicides, accidents or natural deaths, which may be misinterpreted due to secondary cover-up activities of the perpetrator. In addition to that, it is common knowledge that the postmortem examination of strangled victims is prone to errors. A mere external examination of the deceased necessarily leaves part of the strangulation deaths undetected. On the other hand, a homicide by smothering may be covered up as a plastic bag suicide. The literature survey of Maync mentions 6 out of 13 cases in which adult victims were hanged by single perpetrators without significant superiority of physical strength. Thorough planning, in combination with an element of surprise, may be just as effective as mere physical overpowering, especially in unsuspecting victims.