In an attempt to provide more accurate estimates of risks of suicide and attempted suicide in OCD, we analyzed data from the Swedish national registers, including more than 36 000 individuals diagnosed with OCD over four decades (1969–2013). Specifically, we aimed to (i) determine the risk of deaths by suicide and attempted suicide in individuals with OCD, compared with population-matched controls; (ii) determine whether OCD itself is associated with suicidal behavior, after adjusting for comorbid psychiatric disorders; and (iii) identify predictors associated with suicidal behavior among individuals with OCD.