Head lice (Pediculus humanus capitis) infestations are prevalent among young children and generally not considered a health hazard. Although massive chronic head lice infestations have been documented in paleo medical literature, their association with severe iron deficiency anemia has been rarely discussed in modern medicine. A recently published case implicating a head lice infestation as the cause of death of a 12-year-old girl brings this topic to the fore. This contribution discusses the available information concerning the circumstances under which this girl died and the ongoing criminal investigation as a springboard for discussion of how head lice infestations may serve as forensic and legal evidence and as a warning sign of mental illness, abuse, neglect, and rape.