Taiwan has one of the highest suicide rates in the world, especially among its elderly. The epidemiologic characteristics and trends of the surging elderly suicide rates from 1993 to 2003 are described, with a special emphasis on the risk groups, the methods used in suicide, and their geographical variations. Data on annual mortality for persons over 65 years of age with external cause-of-death codes E950ÐE959 were obtained from the Death Certification data file provided by the Department of Health and used in the analysis. The suicide rate for each 5-year age group over 65 years old increased during the 11-year period. Elderly males had the highest suicide rate and experienced an increased rate of 49% during the decade. The average suicide ratio between elderly males and females was about 2:1. Never-married males had the highest age-adjusted as well as sex- and marital status-specific suicide rates, and showed an increased rate of 66% over the 11-year period. Geographical variations in suicide rates were significant, with the lest urbanized eastern Taiwan having a higher rate than other regions. Hanging, strangulation, and suffocation were the most used methods for committing suicide by the elderly, but their use had decreased from 63% to 54% during the decade; but jumping off a building and drowning increased significantly. Variation in suicide rate among months was not significant. With the increase in the elderly suicide rate, more governmental and societal interventions are needed to alleviate this social and human problem.