Four cases of adolescents who committed accidental homicide are presented in terms of how closely the accidental homicide resembles impulsive behavior. The closer the accidental homicide approximates an impulsive act, the more features characteristic of the high risk groups are found. The cases also illustrate the effect of the accident on the adolescent, family, and community, and how each system interacts on the basis of its level of integration. Signs and symptoms that indicate the need for psychiatric intervention are listed, along with factors favoring readjustment.