Suicide in small scale societies is not associated with a process of social alienation as in urbanized societies and the presence of psychiatric illness is less evident. Suicide in these settings is more characterized by a process of reparation, and its implicit goal is often to regain personal or family dignity rather than a simple act of revenge. This review summarizes reports coming from various cultural areas, especially the Pacific islands and Papua New Guinea, and shows how Durkheim’s theory does not fit contemporary data. The other findings are the following: suicide has long existed before radical acculturation and its relationship to social change is complex; contagion seems to play a role at the village level; suicide is not always present when its main risk factors are observed; official statistics are usually not valid when a field study make a thorough enquiry of causes of death and recent increases of suicide may be partially due to better data collection.