The purpose of the present study was to examine the association between repetitive and frightening dreams and suicidal tendency in patients with major depression. Depressed patients who reported frequent nightmare (N = 29) and depressed patients who reported dreaming but never nightmares (N = 34) were evaluated using the Schedule for Affective Disorders and Schizophrenia (SADS) suicide subscale to rate the severity of active suicidality. The patients with frequent nightmares, particularly women, had higher mean SADS suicide subscale scores and were more likely to be classified as suicidal than the others. The findings demonstrate that frequent nightmares are associated with suicidal tendency in patients with major depression. Theoretical and clinical implications for the function of dreaming are discussed. Copyright (C) 1998 by W.B. Saunders Company.