Suicide is a leading cause of death in older adulthood, and most (80%) older men who die of suicide do so with firearms. This paper examines a number of risk factors and precipitating circumstances that contribute to suicidal behavior involving firearms among men aged 65 and older. Data were obtained from the 2003 to 2007 National Violent Death Reporting System restricted access database. Using multivariate logistic regression, a model was developed to differentiate older male suicide decedents who used firearms from those who used other suicide methods. The results show that the presence of a health problem at the time of death was one of the best predictors of suicide with a firearm. Place of suicide (predominantly rural) and veteran status further increased likelihood of firearm use among older men. Suicides occurring in mostly rural counties and in the South were significantly more likely to involve firearms. We conclude with a discussion of the implications for suicide researchers, clinicians, policymakers, and men and masculinity scholars.