The primary objective of the present systematic review was: (1) To explore the current literature which assesses the incidence of completed or attempted mass shooting events in which a female party acted either alone or as an accomplice; (2) Explore the involvement of females in the planning or execution of acts of terrorism; (3) Evaluate the pathology of females involved in these acts of extreme violence; (4) Highlight any gender-specific pathological and environmental risk factors associated with the planning or completion of mass shooting, spree killing, or terrorist attack events. Using the 27-item PRISMA guidelines (Moher, Liberati, Tetzlaff & Altman, 2009), the present systematic review explored peer reviewed literature published betw...