The authors intensively studied 207 patients hospitalized because of suicidal ideation, but not for recent suicide attempts, at the time of admission. During a follow-up period of 5-10 years, 14 patients committed suicide. Of all the data collected at the time of hospitalization, only the Hopelessness Scale and the pessimism item of the Beck Depression Inventory predicted the eventual suicides. A score of 10 or more on the Hopelessness Scale correctly identified 91% of the eventual suicides. Taken in conjunction with previous studies showing the relationship between hopelessness and suicidal intent, these findings indicate the importance of degree of hopelessness as an indicator of long-term suicidal risk in hospitalized depressed patients.