Although there is adequate coverage of serial murder in the extant homicide literature, there is a lack of systematic examination of healthcare professionals who serially murder their patients. Using a sample of 58 healthcare serial killers located within North America, South America, and Europe between the years of 1970 and 2010, this study examines notable pre-offense and post-offense behaviours of healthcare serial killers. Patterns related to offender aetiology, victim cultivation, crime scene behaviour, and techniques of evasion were explored. The findings from this study suggest that the pre-offense and post-offense behaviours of healthcare serial killers can be conceptualised from the theoretical framework of confidence men or ‘con men’. The findings from this study also suggest that healthcare serial killings and offenders who perpetrate them continue to be elusive and warrant additional scholarly attention to reduce their likelihood of engaging in homicide undetected for extended time. Policy implications are also discussed. Copyright © 2013 John Wiley & Sons, Ltd.