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Koro is the conviction that one’s genitals, often male, are shrinking into the abdomen and that this will induce the subject’s death. It is classically described in non-psychiatric subjects in Southeast Asia and can occur in epidemic forms, mimicking some psychopathological mechanisms of mass psychogenic illness. In the Western world, subjects concerned usually have psychiatric comorbidities such as schizophrenia. That is the case with our patient, a male with schizophrenia who committed a pathological homicide because of koro. He was admitted to the Henri Colin unit for difficult patients (UMD). This was the first UMD ever built, and it cares for difficult and dangerous patients.