Psychiatric assessment and management of 22 suicidal attempts in children are reviewed. Intrapsychic and interpersonal conflicts of a serious nature were present in all cases. Most patients demonstrated longstanding, unrecognized disturbed mental states. These were associated with disturbed family relationships in the majority of cases. The child's position in sibling order appeared to be of some significance. It was of interest to find the presence of superior intelligence in all but one patient. Various types of loss were significant precipitating factors. All patients demonstrated a need for hospitalization and immediate treatment based on a thorough assessment of underlying dynamic factors.