The aim of this study was to evaluate suicide trends among individuals < or = 24 years of age in the region of Epirus, northwestern Greece, from January 1998 to December 2008. Twenty-one cases were classified as suicides out of 242 total deaths (8.7%). The male to female suicide ratio was 4.25 (17 males and 4 females). The preferred suicide method for those aged > or = 19 years involved firearms, and for those aged < 19 years was hanging. Alcohol was implicated in more than 50% of the suicides and was consumed exclusively by those aged > 16 years. Suicides by self-shooting were more often related to drinking than suicides by other methods. Children and adolescents (aged up to 15 years), older adolescents (15-18 years) and young adults (19-24 years) had suicide rates of 0.05/100,000, 0.10/100,000 and 0.39/100,000 inhabitants per year, respectively. These suicide rates are the lowest reported so far in Europe. The main reason for this may be the traditional lifestyle of the local population and the strong family ties that protect against suicide, especially for the young.