The manner of death in hangings is virtually always suicide. Uncommonly, accidental hangings do also occur. Homicidal hangings, however, are generally thought to be highly unusual. Despite some case reports of homicidal hangings, retrospective studies have demonstrated that homicidal hangings are virtually non-existent. The present study was undertaken retrospectively to evaluate the incidence of true and simulated homicidal hangings in the forensic population of Quebec (Canada) during a six-year study period. In a total of 251 cases of hanging, suicide was the leading manner of death (239 cases); the remaining cases were accidents (eight cases) and homicides (four cases). This unusually high homicidal hanging rate in Quebec (1.6%) is hard to explain. It could be attributed to an intrinsic particularity of the population and culture. It could also be that our forensic team shares a strong interest in asphyxial deaths as a research topic and, therefore, is particularly alert in detecting such homicides. Nevertheless, this relatively higher homicidal rate may be a reminder that homicidal hangings do sometimes occur. This study emphasises the importance of not disregarding this manner of death in hangings.