Purpose: This study was done to compare suicidal ideation, depression, hopelessness, illness and self-esteem in elderly people who live alone or to live with family. Methods: This was a cross-sectional study. Data were collected through questionnaires from 190 elderly people living alone and 188 elderly people living with family. Data analysis was done with SPSS 12.0. Results: The scores for suicidal ideation, depression, hopelessness and illness of elderly people who live alone were higher than the scores of elderly people who live with family. Self - esteem in elderly people who live alone was lower than that of elderly people who live with family. There were significant differences in suicidal ideation of elderly people who live alone according to the demographic factors of frequency of social contact, disturbance of sleep, and status of employment. There were significant differences in suicidal ideation of elderly people who live with family according to the demographic factor of disturbance of sleep. Conclusion: Results of this study indicate that elderly people who live alone are at higher risk for suicidal ideation than elderly people who live with family. Provision of services to reduce suicidal ideation is especially important for elderly people who live alone.