South Africa has a history of traumatized citizens and is a society in transition. Suicidal behavior among the black population group in South Africa appears to be on the increase. Under the post-apartheid dispensation they are undergoing a lot of stresses especially in relation to their as yet unmet expectations and demands from the government. To identify the possible determinants of suicide in the Transkei sub-region of South Africa. Interviews with relatives of suicide victims, and analysis of victims' demographic, socioeconomic, and psychosocial data. Rural people (> 90%) were much more likely to commit suicide than urban dwellers (< 10%). Suicide notes were left by 13% of the victims. Hanging was the method of choice in 57%, gunshot in 30%, and poisoning in 13%. Among those who died by hanging and by gunshot injuries, males far outnumbered the females (82% and 89%, respectively). By contrast, females constituted the greater proportion of deaths by poisoning (75%). Apparent precipitating factors included economic hardship (87%), alcohol abuse (23%), health related issues (17%), marital problems (13%), and social disputes (10%). The uneducated (70%) and unemployed (64%) used hanging as the method of choice. The highly educated 5 (17%) were all employed, and used a firearm in committing suicide. Family disputes 5 (17%) and separation of parents from teenage children were recorded in 17% of the cases. Financial hardship was the main underlying reason, identified in 87% victims of suicide. To break this vicious cycle of unemployment, alcohol abuse, and poor health, a comprehensive poverty alleviation program along with community education could be an important step towards reducing suicides in the Transkei sub-region of South Africa.