Suicide represents a devastating event that has immediate and long-term consequences to athlete communities. While suicide events are relatively rare, the impact of an athletic suicide is often magnified through media coverage and by nature of the athlete’s prominent place in his or her community. Athletes are often viewed as models for health and wellness and are perceived as unaffected by emotional frailty. Athletes themselves may consider mental illness a sign of weakness and thus may be unwilling to disclose their own concerns to family, friends, coaches, or medical professionals, despite facing many unique stressors that challenge their mental health. Such stressors may manifest as maladaptive behaviours and can lead to suicidal thoughts and behaviours that linger in the silence until too late. Individuals caring for athletes are faced with incredible challenges in both identifying and caring for athletes considering suicide. This chapter aims to review the challenges, potential confounding factors, and strategies for the evaluation and treatment of the suicidal athlete.