Does it always mean they killed someone with two teardrops under the eye?

No, having two teardrops under the eye does not always indicate that a person has killed someone. While in some gang cultures, it is a symbol of having committed murder, it can also represent other meanings, such as mourning or loss. The significance of teardrop tattoos can vary widely depending on cultural context and individual interpretation. Therefore, it's important not to make assumptions based solely on this tattoo.