The aim of this study was to determine whether depressed alcoholics who used cocaine would display a higher prevalence of suicidal behavior and suicidal ideation than depressed alcoholics who did not use cocaine. Forty-one depressed alcoholics participated in this prospective study of consecutively admitted inpatients. Seventeen patients (41.5%) had made a suicide attempt during their current depressive episode, and all but 1 of these attempts occurred during the week prior to their hospitalization. Ten patients used cocaine in the week prior to hospitalization, and 7 of these 10 (70%) had made a suicide attempt during that week. In contrast, only 32% of the depressed alcoholics who did not use cocaine made a suicide attempt during that week (p < .05). Suicidal ideation was also more prevalent in alcoholics who used cocaine. These data provide evidence that cocaine use is associated with an increased prevalence of suicidal behavior and suicidal ideation in depressed alcoholics.