The psychological autopsy has been employed to study risk factors for completed suicide for more than three decades. Despite a wide range in methods of approach to families and interview techniques, the studies show high compliance and remarkable consistency of results across a wide age range and diverse geographic samples. The convergent evidence is that the diagnostic information obtained is both reliable and valid, although it is likely that such an approach will be more specific than sensitive. Integration of data obtained through psychological autopsies with data obtained through biochemical, toxicological, and epidemiological approaches is likely to deepen our understanding of suicide. Successful completion of careful psychological autopsy studies should enable investigators to examine intensively patients who resemble suicide completers, thereby transcending the inherent limitations of this important first step in the investigation of suicide.