Hong Kong has one of the highest rates of elderly suicide in the world (53.0 per 100,000, age 75+). Most of the existing suicide prevention programs have had very little effect on the elderly who rarely use these programs. This paper describes the characteristics of the suicidal elderly, investigates the reason(s) why the elderly are in distress & become suicidal, & formulates a policy & service model to reach this high-risk group. 6 recommendations are made for elderly suicide prevention.