In general, the forensic evaluation of sharp force injuries in living and dead individuals follows the same morphologic principles. Still, there are some special features of sharp force injuries in the clinical context, which have to be considered as examination findings on the living are interpreted to differentiate between accidental origin, self-infliction or homicidal assault. These include the frequency and localization of defence injuries, injuries of the perpetrator, and artificial injuries, especially those inflicted for the purpose of insurance fraud. Characteristics and differential diagnoses of “clinical” sharp force injuries are surveyed in this article.