Background The incidence of homicide-related death among individuals of college age in the United States population is estimated at 15.5/100 000. The incidence of homicide among National Collegiate Athletic Association (NCAA) athletes is unknown.

Aim To investigate the rate of homicide-related death in NCAA athletes and to identify associated risk factors.

Methods The NCAA Resolutions list, NCAA catastrophic insurance claims, media reports, and published NCAA demographic data were used to identify student athlete deaths and total participant seasons from 2003–04 through 2012–13. Homicide-related deaths were analysed by sex, race, division, sport, method, location, and circumstance. Internet searches were used to gather case details.

Results Forty-two cases of homicide-related death were identified from 4 242 519 individual participant seasons during the ten-year study period. The incidence of homicide-related death in NCAA athletes was 1.0/100 000. The incidence in males was 1.45/100 000 and in females was 0.4/100 000 (relative risk (RR) 2.9, p=0.01). The incidence in black athletes was 4.2/100 000 and in white athletes was 0.4/100 000 (RR 7.0, p<0.001). The highest sport-specific homicide-related death rate was in American football (3.7/100 000), with a RR of 4.4 (p=0.002) compared to all other sports. 88% of cases occurred off-campus. 38% of cases occurred at a social gathering, and 38% of cases occurred in a place of residence. 74% involved a fatal shooting.

Conclusions Homicide-related deaths in NCAA athletes occur most commonly in males, black athletes, and American football players. Understanding the incidence, risk factors, and circumstances of homicide-related deaths in college athletes may assist NCAA institutions in developing preventative measures.

Trial registration number University of Washington Human Subjects Application, HSD No. 42077.