The files of the Forensic Science Center in Adelaide, South Australia, were examined for all cases listed as suicide in which death had been caused by the use of a sharp instrument during the 20-year period from January 1981 to December 2000. Fifty-one cases were identified, consisting of 35 men and 16 women. The age range was 23 to 83 years (mean 49 years) representing 1.6% of total suicides (51/3182). Fatal injuries included incised wounds to the arms in 51.4% of men (n = 18/35) compared with 87.5% of women (n = 14/16), incised and stab wounds to the neck in 40% of men (n = 14/35) and 25% of women (n = 4/16), and stab wounds to the chest or abdomen in 28.6% of men (n = 10/35) and 12.5% of women (n = 2/16). In 8 cases, multiple sites were involved. The use of sharp instruments in suicide was favored by older, rather than younger, individuals, with a tendency for women to incise their wrists. Hesitation marks were present in 23 cases (54%) and scarring of the wrists from previous suicide attempts in 5 cases. Although this study demonstrated a higher number of men than women committing suicide by using sharp objects, this method of suicide remains uncommon.