Since 1979, suicide and homicide have alternated as the second and third leading causes of death among young American Indians and Alaska Natives (AI/ANs). From 1979 through 1992, suicide rates for AI/ANs in all age groups were approximately 1.5 times the rates for the overall U.S. population. During 1991-1993, suicide rates for AI/ANs aged 15-24 and 25-34 years were 31.7 and 26.6 per 100,000 population, respectively; males aged 15-34 years accounted for 64% of all AI/AN suicides. In the overall U.S. population during 1991-1993, the rates for persons in these same age groups were 13.0 and 14.5, respectively. Since 1980, suicide has been either the second or third leading cause of death for persons aged 15-24 years in the overall U.S. population. Although knowledge about suicide among AI/ANs has increased, information about the efficacy of suicide prevention and intervention programs in general, and specifically in AI/AN communities, is scarce. In January 1990, following concern raised by tribal officials in 1988 about suicide among youth, a Western Athabaskan tribe in rural New Mexico implemented a suicide prevention and intervention program that targeted tribal members aged 15-19 years. This report summarizes the results of the program through 1997 and indicates that rates of suicide and attempted suicide among this target population decreased substantially after the program was implemented.