Suicide research on epidemiology, service utilization, and prevention strategies tend to focus on urban areas, resulting in a conceptualization of suicide that may not be applicable to rural populations. Rural areas have differing geographical, socioeconomic, political, and cultural characteristics that must be considered in the development and implementation of evidence-based suicide prevention strategies. Many countries have identified rural suicide as a major public health concern and share common challenges in developing prevention strategies. To address these issues, in June 2009, researchers at the University of Toronto and Tsinghua University, Beijing, China, held a symposium entitled “Improving Rural Mental Health Care in China and Canada to Prevent Suicide.” This ongoing collaboration focuses on highlighting similarities and differences in rural suicide between countries and the identification of shared barriers to care and common strengths and challenges in suicide prevention. This collaboration has informed the development of a matrix model of rural suicide prevention that is evidenced-based, providing a selection of interventions targeting specific risk factors for rural suicide while allowing for flexibility to address social and cultural issues. This article illustrates a matrix model of rural suicide prevention by focusing on a comparative analysis of rural suicide in Canada and China.