Death by suicide has become a growing problem among teenage and young adult males over the last 20 years. Concurrent with the increase in the rate of adolescent suicide has been the observation of its increasing tendency to occur in clusters. Cluster suicides are defined in the literature as any series containing more than three deaths, closely associated in space and time. Two important factors are apparent about cluster suicides at the present time: (1) the phenomenon is largely limited to adolescents and appears more strongly among females than among males and (2) imitative behavior appears to be a major link between serial suicides in a cluster and the process of imitation may be spurred either by personal knowledge in a close community or by media coverage. Research describing a common database of completed adolescent suicide over an 8-year period of time on a Pacific Northwest Indian reservation found the suicide group to be differentiated from the control group by several factors related to an unstable home environment and greater instability of family relationships. Lessons to be learned include: (1) practitioners need to acquire an understanding of the risk factors for adolescent suicide in Indian communities; (2) additional understanding of the culturally specific pattern of Indian suicide; and (3) be aware that cluster suicide is a phenomenon that cuts across culture and several other factors. The general characteristics of adolescent suicide are reviewed, as are the special characteristics of cluster suicide, and the culturally specific patterns of suicide among Indian people. Cluster suicide among teenage and young adult males of a Plains Indian tribe is described. Figure and references