A multidisciplinary approach in a forensic case study of a skeletonized child homicide victim.

Child homicide represents a severe form of violent crime, and cases identified exclusively through skeletal remains are uncommon and pose particular forensic challenges, requiring a multidisciplinary investigative approach. We report a Romanian cold case involving a 5-year-old girl who disappeared in 2006 and whose remains were discovered in 2021 in a shallow grave beneath rose bushes on her father's property. Clothing analysis revealed nine perforations consistent with sharp-force trauma, subsequently confirmed through forensic reconstruction. The remains were completely skeletonized and osteological examination documented perimortem injuries affecting two ribs on the left side. Micro-CT identified V- and Y-shaped lesions with cortical fissures referring to a knife penetration. XRF showed increased iron and zinc at wound margins, suggesting metallic transfer. Death was attributed to multiple stab wounds to the left hemithorax. Genetic analysis confirmed both the victim's identity and paternity. Psychiatric evaluation of the suspect established full legal responsibility. This case illustrates the evidentiary value of a comprehensive medico-legal approach integrating forensic anthropology with clothing analysis, advanced imaging, physicochemical methods, genetic testing, and psychiatric expertise, enabling the identification of a homicide and the legal resolution of a one-and-a-half-decade-old crime.