Objectives To compare 12-year suicide-specific mortalities of 3 different injury cohorts, identify the risk factors for suicide mortality after spinal cord injury (SCI), and investigate whether suicide mortality is higher among those with SCI than in the general population. Design Retrospective cohort study. Setting United States hospitals (n=28) designated as SCI Model Systems. Participants Participants (N=31,339) injured between January 1, 1973, and December 31, 1999. Interventions Not applicable. Main Outcome Measure Suicide death after SCI. Results The crude annual suicide mortality rate during the first 12 years after SCI was 91 per 100,000 person-years for 1973 to 1979 injury cohort, 69 per 100,000 person-years for 1980 to 1989 injury cohort, and 46 per 100,000 person-years for 1990 to 1999 injury cohort. Suicide mortality was associated with race, injury severity, and years since injury. The standardized mortality ratios for the 3 cohorts were 5.2, 3.7, and 3.0, respectively. Conclusions Suicide mortality among those with SCI decreased over 3 injury cohorts, but it still remained 3 times higher than that of the general population. © 2014 by the American Congress of Rehabilitation Medicine.