This paper explores the intrapersonal and sociocultural factors behind youth suicide in Hong Kong. The coroner's court reports of consecutive population-based youth suicide (below age of 25 years, n = 303) cases from 1986 to 1992 were reviewed. Compared with other countries, Hong Kong had low male but high female youth suicide rates. The number of undetermined deaths did not significantly affect the estimated suicide rates. Cross-cultural differences in youth suicide rates may be understood from a differential distribution of risk factors and cultural attitudes towards role behaviours and suicide. Youth suicides in Hong Kong were characterised by a high prevalence of psychiatric disturbances and age-normative precipitants; both findings bear great resemblances to samples studied elsewhere. The results were evaluated in light of studies in different sociocultural backgrounds and highlighted the universality and specificity of youth suicide in Hong Kong.