This research investigates violent stranger rapes and the factors leading these cases to sexual homicides. Variables relating to modus operandi characteristics on one part and offender behavior on the other part are examined using conjunctive analysis of cases configuration to identify the different combinations leading to a lethal outcome. Using a French sample of 1263 cases of violent rapes and 303 cases of sexual homicides involving female adult victims, we find that blows given by offenders and information about physical resistance of victims are strongly associated intentional and non-intentional sexual homicides. Psychoactive substance consumption by offenders as well associal isolation are in a lesser extend also associated with the lethal outcome.