Strangulation involves the application of force to the neck to restrict blood flow or breathing. It is often utilized in both homicides and non-fatal incidences of coercive control, interpersonal altercations, and sexual assaults. The intention of this study was to provide a comprehensive understanding of interpersonal fatal strangulation in Australian adults through the documentation and analysis of characteristics and circumstances involved in these fatalities. Currently, there is limited research within this field in Australia leading to a medico-legal knowledge deficit that needs to be rectified to ensure public health intervention and preventative death policies and initiatives. Researchers conducted a retrospective review of all closed interpersonal strangulation coronial cases within Australia between 2000 and 2021 using the National Coronial Information System online repository. Researchers identified 195 cases to be included in the study. Strangulation currently accounts for 1.1% to 5.8% of all assault fatalities in Australia per year. Most victims of strangulation are women (68.2%), under the age of 45 (52.3%), and Anglo-European (73.3%). Most individuals are killed by someone they know (89.2%), often in the context of intimate partner violence (52.3%). The leading cause of death within the sample is directly related to the strangulation (90.8%), and the leading manner of death is homicide (94.4%). The study is the first of its kind to utilize descriptive forensic epidemiology to explain the circumstances and characteristics of fatal interpersonal strangulation in Australia providing an Australia-specific medico-legal voice to aid in future research, policy development, and criminal prosecution. The findings within this study are foreseen to contribute to improvements in public health policy surrounding fatal and non-fatal strangulation and assist future medico-legal death investigations, and provide LGBTQ+ and Indigenous Australian representation, which has not been considered in previous studies.