Now the family of the woman he was accused of murdering is left yearning for justice, while the public remains captivated by the fit-for-Hollywood story of a medical student accused of soliciting a masseuse on the classified ads website Craigslist and shooting her dead during a botched robbery scheme in a posh Boston hotel.
Ultimately, Markoff chose his own ending: Suicide.
Authorities completed an autopsy Monday but were waiting for the results of specialized tests before releasing the cause of death.
Family members of slain masseuse Julissa Brisman were angry they won't have the chance to confront Markoff at trial and hear the details of their loved one's final moments, said a lawyer for Brisman's mother, Carmen Guzman.
"First he took their daughter from them, then he denied that opportunity for them," said the lawyer, Djuna Perkins. "The criminal trial allows them to confront the suspect, hear the evidence and reach some resolution in the case."
Markoff was arrested in April 2009 on charges of binding, beating and shooting the 26-year-old Brisman with a gun that prosecutors say he later stashed in a hollowed-out anatomy textbook. He became instant tabloid fodder and a cover story in People magazine.
"It has sex, it has enigma, it has the story of a respectable, smart, success-oriented, helpful young man who, without warning, becomes a killer, and that is why people pay attention to it," said Jack Levin, a professor of sociology and criminology at Northeastern University in Boston who has written books on murder.
Authorities charged him in two other attacks — including the armed robbery of a Las Vegas woman at another Boston hotel and the assault of a stripper inside a Rhode Island hotel where authorities found his fingerprints on the wall. The three crimes occurred within a week.
Markoff, 24, was taken into custody during a traffic stop as he and his then-fiancee, Megan McAllister, were driving to Foxwoods Resort Casino in Connecticut, six days after he allegedly shot Brisman in the Marriott Copley Place Hotel in Boston's historic Back Bay district. Authorities say he lured her and botched a robbery to support a gambling habit.
His expressionless demeanor during his first court appearance was a stark contrast from his broad smile in a 2007 photograph taken as he donned a white coat at a ceremony for incoming medical students at Boston University.
His personal life came undone as prosecutors presented evidence they said linked him to Brisman's killing and other attacks of women who advertised in Craigslist's "erotic services" category.
McAllister, who met Markoff in 2005 while volunteering at a medical center, ended their relationship and canceled plans for a beachfront wedding. Saturday was to have been their wedding anniversary.
Markoff had pleaded not guilty in Brisman's death and was to have stood trial next March amid evidence that prosecutors said included blood stains taken from swabs on a handgun found in his Quincy, Massachusetts, apartment.
The Suffolk County district attorney's office announced the apparent suicide Sunday but did not say how he died. Various news reports, citing unnamed sources, have said he was found with a plastic bag over his head and with stab wounds or cuts to his body.
He had been placed on suicide watch just days after arriving at the Nashua Street jail after authorities reportedly noticed marks on his neck. In his fatal attempt, he used a pen to cut arteries and covered his head with a plastic bag, the Boston Herald reported, citing anonymous sources. The newspaper also reported that he had not been checked all night.
Suffolk County recorded an average annual rate of 10 suicides per 100,000 jail inmates between 2000-2007, according to a report by the Bureau of Justice Statistics. Nationally, the average rate during that time was 42 suicides per 100,000 jail inmates, the report said.
Sheriff Andrea Cabal said the county books 9,000 to 10,000 inmates annually, and her guards prevent an average of 57 suicides each year. She said there have been five inmate suicides since 2003, including Markoff's.