Background: To analyze suicidal care episodes in emergency medical responses in Germany. Method: Anonymized data from emergency care episodes in Ulm from 2004 to 2013 were analyzed retrospectively. Results: 158 of 933 psychiatric emergencies (16 %) were suicide related, including 14 completed suicides, 25 careepisodes with suicidal ideation, and 119 suicide attempts. Significantly more men than women completed suicide(χ²(2,N = 934) = 12.70, p = 0.02). 93 % of the total psychiatric emergencies received any medication at all, and only about 33 % were transported to a psychiatric hospital. Conclusion: Psychiatric treatment for suicidality in emergency medicine requires improvement to ensure that patients receive adequate therapy.