The aim of this study is to update age and sex mortality rates for suicide in Italy; to evaluate the methods of suicide; to consider the effect of under-reporting on mortality rate for suicide; to compare age-adjusted mortality rates for suicide; and to examine some possible causes for the misclassification of suicide. Temporal trends, from 1980 to 2002, were analyzed using joinpoint regression. Suicide rates decreased from 1980 to 2002 by 10.5% for men and by 44% for women. The change in suicide methods indicated an increasing use of highly lethal methods. The under-reporting of suicide seems to have no effect on temporal changes in mortality rates or on the geographical distribution. These data indicate that Italy is a country at low risk for suicide.