An elderly gunman shot dead two doctors and apparently his own wife in the west German city of Ludwigshafen before killing himself, police said.
The 69-year-old Italian national stormed into the offices of the two doctors, killing one instantly and fatally injuring a second before turning his gun on himself as police closed in.
Police later found the unnamed man's 71-year-old wife dead in their apartment and said they assumed he had killed her too.
No motive has yet been established for the killings which, the BBC's Ray Furlong reports, came as Germany appeared to be getting on top of its gun crime problem.
The two doctors were shot at separate practices, the killer entering and opening fire at the second office 20 minutes after the first.
One doctor was 45 and the other, who died of his wounds in hospital, was 37.
The gunman only shot himself after police stopped his car.
Germany's problem with gun crime, our correspondent says, came to light last year when a youth in the eastern city of Erfurt killed 16 people.
His weapons were legally held, but the real problem is the vast number of illegal firearms which arrived in Germany during the Balkan wars of the 1990s.
However, gun crime has come down sharply with the statistics for 2001 showing a drop of 10% on the previous year.