The neuropsychological and clinical correlates of extreme violence were examined retrospectively in young and older inpatients of a forensic psychiatric hospital. The young group exhibited significantly higher rates of both a learning disability and a history of childhood conduct disorder, whereas the older group had a significantly higher rate of psychosis. The older individuals charged with murder were also more likely to have acted alone and to have had an intimate relationship with the victim. These results suggest that age, specific clinical and neuropsychological variables, and the characteristics of the violent act may represent important variables for risk models of violence.