Elder homicide is a fatal outcome of elder abuse and neglect. Multifactorial homicidal asphyxia in an elderly man by combination of three different mechanisms is an uncommon incident. This following case demonstrates a very unusual murder of 74-year-old man in his own residence. Crime scene visit and postmortem examination revealed that the victim was killed by combined effect of ligature strangulation, traumatic asphyxia and smothering by plastic bag.