Abstract: Objective To explore the relationship between family cohesion,adaptability and suicide among rural residents and to provide reference for suicide prevention and intervention. Methods With paired case-control study,25 towns from 3 counties in Shandong province were randomly selected.Case group was the suicide happened from Sept 1, 2008 to Aug 31,2009 in the 25 towns.Controls were normal persons matched with same age(no more than 3 years), gender,and same or neighbor village as suicide cases.The data of 200 suicide cases and 200 paired controls were collected with psychological autopsy method. Results There were significant differences between suicide and control groups in family cohesion(74.83±13.14 vs 65.82±14.64)and adaptability(57.46±9.59 vs 50.72±14.17).The percents of balance, intermediate,extreme family type in suicide group were 13.5%,26.0%,and 60.5%,respectively.The percents of those three family types in the control group were 27.5%,23.5%,and 49.0%,respectively,and the family type was associated with suicide(χ²=12.299,P<0.01).Multivariate conditional logistic regression model analyses showed that single,mental illness,experiencing negative life event,and extreme family type were risk factors of suicide.Party/league member,having high family income were protective factors of suicide. Conclusion There are defects in family cohesion and adaptability among the suicides.The persons in a family of extreme type are more likely to have suicide behavior.