The evolution between 1990 and 2001 in suicidal behaviour in Flanders was analysed. The suicide rates for 2001 constitute an increase in comparison to 1990. These figures are higher than in neighbouring countries, where suicide rates decreased during the same period. The interpretation of this difference remains unclear. The increase in suicide rate is more pronounced in men than in women. Only in the eldest groups we see a decrease in suicide rates. Suicide is the second most important cause of death in the youngest age group (15-24 years of age) and the most important cause of death in 25-44 year old men. In older age groups the importance of suicide in comparison with other causes of death decreases. In males as well as in females, there was little evolution in the methods used to commit suicide. Depending on the registration method, we estimate the number of suicide attempts between 79 to 146 per 100 000 inhabitants. In between 29.3 and 51.8% of the cases these attempts are brought to the attention of the general practitioner in the first place, and the majority are subsequently hospitalised.