We examined the relationship between suicidal ideations and attempts in 95 probands with pathological gambling (PG), 91 controls, and 1075 first-degree relatives. The results were analyzed using logistic regression with generalized estimating equations. Thirty-four PG probands (35.8%) and 4 controls (4.4%) had attempted suicide (OR = 12.12, p < .001); in 13 probands, the attempt occurred before PG onset. Lifetime suicidal ideations occurred in 60 PG probands (63.2%) and 12 controls (13.2%) (OR = 11.29, p < .001). Suicidality in PG probands is a marker of PG severity and is associated with greater psychiatric comorbidity. Offspring of PG probands had significantly higher rates of suicide attempts than control offspring.