Ingestion of pesticides is the most common suicide method worldwide, accounting for one third of all suicides, predominantly in Asia, Africa, Central and South America. Case fatalities are high, particularly in rural areas. This high case fatality may explain the similar numbers of male and female suicides in Asia, since more women die from their attempts. In Asia, pesticide suicides are mostly impulsive acts with little advance planning and they are less often associated with mental illness than in Western countries. Pesticides are generally chosen for their easy access. Prevention strategies include treating the problems leading to suicidal behaviors involving pesticides; changing attitudes, knowledge, and beliefs about pesticides; controlling access to dangerous pesticides, including developing secure storage practices (which are currently being evaluated); and improving the medical treatment of poisonings. More research is needed to better understand suicides involving pesticides in their cultural contexts and to evaluate the effectiveness of intervention programs, including assessment of possible substitution of methods. Also, more knowledge about protective factors may help suggest innovative prevention strategies.