AbstractSix cases of serial murder by children and adolescents spanning the past 150 years are presented. The available literature pertaining to this area is reviewed. Each of these six offenders committed sexually homicidal behavior as demonstrated by their expression of erotic interest or engagement in overt sexual behavior at the crime scenes. From a DSM‐IV‐TR perspective they all exhibited signs of sexual sadism, and their crime characteristics reflected behavior of a more predatory than affective nature. Hands on methods of killing were preferred, i.e., cutting, stabbing, or strangulation. These crimes are extremely rare. Case reports in this area are encouraged to advance our knowledge of these youths. Copyright © 2004 John Wiley & Sons, Ltd.