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Strangulation is one of the most lethal forms of violence employed by perpetrators of intimate partner violence, and the overwhelming majority of strangulation incidents–that do not result in death–result in little or no visible injury to the victim. Lack of visible injury can result in the misidentification of strangulation injury and an inability for medical professionals to provide meaningful intervention and treatment. In the absence of visible injury, other telltale symptoms may be present, and it is critical for law enforcement officers and other first responders who interface with victims in the aftermath of an assault to be able to identify these symptoms of strangulation as a component of the violence. This presentation will address common myths and misconceptions related to strangulation injury and focus on the signs and symptoms of strangulation injury, medical evaluation and documentation, delayed fatalities, and risk factors.