In the Western world, men are particularly vulnerable to suicide, so it is important to undertake research that helps explain the manifestation of suicidality. This is one of the few studies to date that have researched men who were sexually abused in childhood and their presentation of suicidal ideation, much of the previous research with this focus having been restricted to women. The study draws on a clinical sample of 147 Australian men who were sexually abused in childhood, of whom thirty-nine also gave open-ended interviews, and comparisons are made with a community sample of 1,231 men. It was found that the sexually abused men were up to ten times more likely to report suicidal ideation than the controls. To understand risk factors for suicidal ideation, a predictive regression model was constructed, the most important variables in this model being self-blame, isolation and physical injuries sustained from the abuse. These variables are further explored and illuminated from the qualitative data. Key implications of the study for social work practice include the need for screening and assessment of men in clinical populations as well as in other vulnerable populations. Limitations of the study and future areas of inquiry are also outlined.