This exploratory study compares elderly suicides with (n = 13) and without (n = 72) family member suicide. Previous episodes of suicidal behavior were more common among suicides who lost first-degree relatives by suicide (100% vs. 65%, p = 0.009). Six persons had lost an offspring by suicide prior to their own deaths. Substance use disorder was more prevalent among those with offspring suicide than those without (100% vs. 25%, p = 0.000). While informants reported that offspring suicides played a central role in the suicide of the elderly study case, sibling suicides were not considered precipitating factors.