Typical reasons for alerting the rescue helicopter are medical emergencies like heart diseases, accidents, and neurological emergencies. There is also a small number of patients with attempted or completed suicides. The aim of the study was a general analysis and evaluation of special circumstances of emergency cases associated with suicide or attempted suicide in the prehospital setting performed by the rescue helicopter (HEMS) “Christoph 38” from the German Air Rescue (DRF Stiftung Luftrettung gAG®) based in Dresden, Germany. Data of all emergency missions performed by the HEMSin Dresden, Germany between January 2008 and December 2014 were analyzed by examining the DIVI-rescue-mission-minutes and the electronic data (MEDAT®, HEMSDER®) about suicide-related variables. Timing, methods, and information about the reason, socio-demographic data, and outcomes of medical treatment were collected and retrospectively analyzed. There was a total of 10.238 cases of emergency during the study period. Of these, 173 cases (1.69%) were related to suicide. The average time for the HEMS to arrive at the scene was 11.13 minutes. There were 31 patients with a completed suicide, 115 with a suicide attempt, and 27 patients with a suicide threat. 24 patients were announced dead before or at the time of the HEMS arrival. Of the 149 still alive at the arrival time of the HEMS, 36 were endotracheally intubated and mechanically ventilated, and 18 patients received cardiopulmonary resuscitation. In 15% of patients, health problems were detected as the main reason for the suicide attempt. In another 13.9%, partnership problems or the loss of a partner were reported. The most frequent method used was overdosing (42.77%), followed by hanging (12.7%) and jumping from height (8.7%). Stab wounds and gunshots were observed in 8.7% of the cases. The overall mortality rate was 18%. The method used, the gender and a suicide note could be shown as possible influencing variables for the fatal outcome of a suicide. At all, there is a small number of HEMS for suicide victims. However, the mortality in these operations is rather high. Some factors and circumstances could be shown, but many backgrounds and explanations are still missing. Thus, this study demonstrates a general need for more research leading to better prevention as well as improvement of education and training for emergency teams.