Old age males have the highest rates of suicide compared to other age groups. The rates of suicide are nonetheless strikingly high even among senior women. Depression may onset in the elderly, and the old-age patients may seek for primary care or otherwise non-psychiatric consultation in a high proportion of cases. When they do not do so, suicide in the elderly may be insidious since the aged individual is poorly verbally communicative, and the final suicidal attempts bare high in terms of lethality. The prevention of suicide using the identification of relevant risk factors and optimal management is, therefore, a multidisciplinary priority for treating physicians. Antidepressant and patient-tailored social interventions are among the most relevant therapeutic approaches, although additional insights about the neurobiology and psychological factors leading to suicide in the elderly are warranted. © 2019 Elsevier Inc. All rights reserved.