BACKGROUND: Non-fatal strangulation (NFS) is a major risk factor for female homicide. Victims may present in a variety of clinical settings. In this study, we analysed reported signs, symptoms and injuries following NFS. METHODS: This is a clinical audit of 170 NFS victims who underwent a documented clinical examination, including forensic photography. RESULTS: Patients reported neck pain (77.6 %), an inability to breathe (60 %), headache (55.9 %), sore throat (52.9 %) and voice changes (47.1 %). In 76.5 % neck injuries were detected comprising non-petechial bruising (59.2 %), linear abrasions (scratch marks) (25.4 %), neck swelling (12.3 %), petechial haemorrhage (7.7 %) and ligature marks (1.5 %) with no detectable neck injury in 23.5 % of cases. There was no typical patient profile of NFS signs, symptoms or injuries or correlation of any signs, despite extensive interrogation by statistical analyses. CONCLUSIONS: To assist with therapeutic care and forensic evidence collection following NFS, signs, symptoms and injuries should be documented. A lack of detectable injury to the neck following NFS does not exclude NFS. In addition, detectable injury may indicate a defensive response by the patient and/or multiple applications of force.