This article discusses the paired suicide using a number of case studies drawn from a sample of cases of paired suicides in Yorkshire and the Humber. Worldwide, suicide is the tenth leading cause of death; 1.5 per cent of all deaths are the result of suicide, a rate of 14.5:100,000 individuals per year ( Windfuhr and Kapur, 2011). In 2010, there were 5,608 suicides in people aged fifteen years and over in the UK ( ONS, 2012). Paired suicides, often called suicide pacts, in which two people die together, are a small fraction of suicides overall but are a persistent and devastating phenomenon. Cases were included in the study only when the suicides occurred together in the same place and within twenty-four hours. The term ‘paired suicide’ is used here because the suicide pact is quite difficult to define, due to a number of contextual factors. Social workers have a key role to play in the prevention of suicide, and will encounter the kinds of cases discussed here in their work in mental health teams, drug and alcohol services, practice with offenders and community care practice with the elderly. The article therefore concludes with a discussion of the implications for collaborative practice.