Despite increasing attention to psychiatric disorders in the mentally retarded, suicidal behavior remains an underreported phenomenon in this population, particularly in children and adolescents. This study was aimed at documenting the existence of suicidal behavior among 90 consecutive admissions to a specialty unit for dually diagnosed children and adolescents in a medical school-affiliated children's psychiatric hospital. Archival chart review yielded a total of 19 patients, or 21%, for whom suicidal behavior was a presenting complaint upon admission or during hospitalization. Suicidality was distributed across gender, level of mental retardation, and psychiatric diagnosis. Additional findings of note with regard to family dysfunction and/or abuse history are summarized. Clearly, in this sample, children and adolescents with mental retardation were capable of formulating and engaging in potentially fatal acts. Results of this study suggest that suicidal behavior is an underrecognized, yet significant phenomenon in children and adolescents with mental retardation and psychiatric disorder.