Guided by Durkheim’s classic theory of suicide, this article examines suicide trends and determinants in Eastern European countries for the period of 1989–2006, with particular attention given to the association between postcommunist social change and suicide mortality. I find that countries characterized by more drastic structural change experienced increased suicide rates during the period immediately after the fall of communism. Yet continued reforms were associated with reductions in suicide in more recent years. Further, I observe large gender differences in suicide patterns. Male suicide rates are consistently and strongly related to structural change, while female rates remain almost unaffected. By directly and statistically substantiating the relationship between postcommunist transition and suicide death rates, this study provides a more thorough and textured account of the social consequences of the fall of communism in Eastern Europe.