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This chapter seeks to shed light on the many factors that contribute to people becoming school shooters. These factors are divided into four domains: biological, psychological, social, and cultural. At the biological level, this chapter explores the potential influence of genetics, pre- and post-natal development, and body-related issues that may affect the perpetrators' sense of self. A psychological typology is presented, consisting of psychopathic, psychotic, and traumatized school shooters. Socially, school shooters often have multiple setbacks, failures, and rejections that contribute to their distress. Finally, the cultural domain includes such factors as media violence, role models for killing, and ideologies of hatred and supremacy. Rather than attributing school shootings to a simplistic cause such as bullying, this chapter discusses a wide range of potential influences that combine to cause mass attacks at schools.