This systematic review explores the critical link between peripartum psychosis (PPP) and suicide-related outcomes in childbearing individuals, aiming to highlight the urgent imperative to understand and address this nexus to improve maternal mental health outcomes. PPP, a significant mental health concern affecting 1-2 of every 1,000 childbearing individuals, is markedly associated with an increased risk of suicide-related outcomes, necessitating the development of tailored interventions for peripartum populations. A variety of search and mesh terms including ‘peripartum’, ‘perinatal’, ‘psychosis’, ‘suicide’, and ‘suicide-related’ were used to query MEDLINE via PubMed, Web of Science, EBSCO, and Google Scholar to identify all articles on PPP and suicide related outcomes that were published between 2003 and 2023. Seventeen of the 464 identified articles met our inclusion criteria [i.e. original publication in English, produce quantitative results, include suicide as an outcome and peripartum psychosis as an exposure, and assesses childbearing persons as the primary population] based on three assessors that had a concordance of 82.8. 16 articles used a cross-sectional and 1 used a case-control design that were assessed to have fair to good quality based on reliabilities of 78.42 (cross-sectional) and 77.78 (case-control) between the three independent assessors. The review delineates a pronounced correlation between PPP and suicidal ideation with 19% to 38% of individuals with PPP reporting suicidal ideation. The review highlights PPP as a robust predictive factor for self-harm during pregnancy (adjusted Hazard Ratio = 6.36; 95% Confidence Interval [CI] 4.30–9.41). Moreover, it is noted that suicide completions in the first year postpartum are more prevalent among individuals with psychotic disorders (adjusted Risk Ratio = 83.69; 95% CI 36.99–189.31). These insights accentuate the complexity of PPP and suicide-related outcomes, advocating for an integrated care framework that incorporates targeted screening and early intervention to mitigate risk. This review asserts the need for advancements in clinical practices and policies to strengthen support for the mental well-being of childbearing individuals and propounds the necessity for future longitudinal research to further unravel causative links and foster proactive prevention and treatment measures.