Suicide in the geriatric population is a significant problem. Increasing age, living alone, having a psychiatric illness and medical comorbidities have been identified as risk factors for suicide among the elderly population. The elderly population in South East Asia is rapidly growing and the number of elderly people with mental illness and/or medical comorbidities is also increasing. The factors and attributes of suicide may vary from region to region due to socio-cultural and geographic diversities. Understanding these factors may help in planning suicide prevention strategies for the elderly population. There is a dearth of studies assessing the demography, risk factors for, and prevention of suicide among the elderly population in South East Asia. We tried to observe and explain the challenging paradigms to excerpt attributes and the context of geriatric suicide. It is observed in this review that lack of social integration or interaction along with some psychiatric disorders leads to suicidal ideation and completed suicide in the elderly. South East Asia has unique characteristics in several aspects like religious and cultural diversity, poverty, unemployment, demographic structure of the region, migration, natural disasters and calamities, political environment, poor policy implementation, and easy access to suicide means (e.g. pesticides). Primary care physicians, specialized mental health support, gate-keeper training, means restriction, raising awareness, supportive family environment, and dedicated call centers could be potential areas for suicide prevention among the elderly people of the region. Further studies are warranted to formulate effective suicide prevention strategies.