To prevent intimate femicide an understanding of the perpetrators is necessary. The purpose of this systematic review was to synthesize the evidence on intimate femicide with a focus on the perspectives of male perpetrators. We searched ten databases using terms about femicide and perpetrators (e.g., husband). The review had no limits on publication date, geography, study design, or discipline and included articles in English, Spanish and Portuguese. The search resulted in 4,273 articles; after exclusion criteria were applied the full text of 112 articles was reviewed. Data were extracted from fourteen studies. All studies sampled incarcerated populations. Articles used varied terminology and were grounded in gender and power, psychology, or social development theory. Most used qualitative approaches (n=11), primarily semi-structured interviews (n=8). Common themes across studies included perpetrator biographical and predisposing factors, self-narratives, and sense-making. Perpetrators rationalised the femicide and deflected responsibility; viewed themselves as the victim while vilifying true victims; and adhered to strict gender norms. Femicide accounts and stories shared strikingly similar narrative patterns relative to violence and conceptions of gender roles. This review underscores the importance of and absences in work focusing on intimate femicide perpetrator’s perspectives across methodologies and disciplines, namely criminology and masculinity studies. Intimate femicide perpetrators are not merely individual offenders, instead they are a manifestation of a global patriarchy who pose mortal threats to their female partners. As drivers of intimate femicide, information about perpetrator motivations and rationalisations is necessary for effective policy and programmatic interventions to save women’s lives.