Within the past two years, we have encountered two cases where homosexual incest seemed to be a potent predisposing factor in extreme pathological behavior. In order to better understand what we were contending with, an extensive search and review of the literature was undertaken and the two case histories analyzed in detail. Our conclusions include: (1) that homosexual incest is at times unrecognized by therapists and therefore not dealt with to alleviate torment and sometimes to avert tragic consequences; and (2) that it is underreported so that information is lacking and essential dialogue on dynamics and treatment rarely occurs. It is hoped that this article will stimulate awareness of the phenomenon and foster exchange of ideas regarding etiology, psychodynamics, and intervention.