On Sunday (24 March), Medellín recorded five separate murders within a 24-hour period, bringing the total number of homicide victims in the city during 2019 to 141. This represents a 15% increase on the figure recorded in March last year and continues the rising trend in violence that has been evident since 2015. According to Medellín's mayoral office, there were 626 homicides during 2018, an increase of nearly 8% on 2017. Hotspots include: Comuna 10 (Candelaria), Comuna 12 (La América), and Comuna 7 (Robledo), as well as Comuna 13 (San Javier), where homicide numbers have nearly doubled from 48 cases in 2017 to 91 cases in 2018. The Bello municipality, on Medellín's outskirts, has also seen rising levels of violence, leading authorities to ban riders from having passengers on motorbikes in an effort to clamp down on drive-by shootings.

The recent rise in homicides has revealed shortcomings in the security strategy pursued by Mayor Federico Gutiérrez Zuluaga. Although his administration has prioritized the capture of criminal leaders, enabling some high-profile arrests, this has failed to dismantle the illicit structures over which these individuals presided. Indeed, some arrests are likely to have fostered violent competition between and within the city's criminal groups who seek to take control of vacated drug-trafficking and small-scale extortion activities. In December 2018, there were 12 registered shootouts between the city's two major criminal structures, La Oficina de Envigado and La Alianza de Estructuras Criminales. Although the majority of victims have some link to organized crime, there have been reports of an increasing number of locals who are unconnected with such activities who have been injured or killed in gang shootouts. In late December, for example, a graphic designer in Laureles, one of the city's more affluent districts, was killed when criminals opened fire on a bar where their rivals were assembled. In February 2018, a metro carriage was hit by bullets near Cisneros stations. In April that year, a metro carriage was evacuated on Line J as a result of a gunfight in Comuna 13. There will be indicators of an escalation in collateral injury risks for foreign visitors should there be an increase in violence in the upmarket Pobaldo district, or along popular tour routes through Comuna 13.