This Morbidity and Mortality Weekly Report (MMWR) discusses suicides among American Indian or Alaska Native (AI/AN) people. It provides a comparison of 2015–2020 suicides among all AI/AN and non-AI/AN decedents in 49 states, Puerto Rico, and the District of Columbia and recommends the use of culturally relevant comprehensive public health approaches to suicide prevention to address systemic and long-standing inequities among AI/AN persons.