Suicide is a widespread problem that is severely underreported within the fire service. There is a growing body of evidence that suggests firefighters are at increased risk of committing suicide compared with their civilian counterparts due to disturbingly higher rates of posttraumatic stress disorder and substance use disorders, which serve as markers for suicide completion. The main problem for mental health professionals in addressing suicide in this population is the substantial lack of empirical research on mental health of firefighters as well as the compounding cultural stigma that exists in addressing mental and behavioral health issues. Additionally, there remains a discrepancy in reported rates of suicide and a lack of information on attempted suicides—related to low reporting rates by family members, fellow firefighters, and departments, as well as no official national tracking database for suicide in firefighters—that further complicates research in this area. This article (a) discusses current research on suicide within the fire service, (b) explores issues and challenges for psychological assessment and intervention for practitioners working with this population, (c) describes specific approaches toward decreasing suicide in firefighters, and (d) suggests policy considerations for fire departments and mental health professionals.