Suicide is the 11th leading cause of death in the United States and in 2001 accounted for approximately 30,000 deaths. The authors examined 2,864 cases of suicide occurring in Kentucky between 1993 and 2002. Each case was reviewed for age, race, and sex of the victim as well as the location of death, presence of a suicide note, and investigation-derived recent life stressors. Results showed that suicide victims ranged in age from 11 to 96 years and were 81.7 percent male and 94.8 percent Caucasian. Firearm was the mode of death in 67.5 percent of cases, followed by hanging in 13.7 percent of cases, overdose in 9.9 percent of cases, and carbon monoxide poisoning in 4.4 percent of cases. Various life stressors were identified as potentially culpable in the suicide, including domestic turmoil (20.5 percent) and employment-related stress (3.1 percent). Trends in suicide during the 20th century are described and the importance of a multidisciplinary approach to investigation and prevention strategies is underscored. Tables, references