Objective—The overall suicide rate in French Guiana is estimated at 7 per 100,000, which is lower than that of metropolitan France. However, the majority of suicide cases are reported in Amerindian communities. Based on the hypothesis that the overall rate did not reflect a more varied reality, the objective of this study was to determine the rates of suicide attempts in remote municipalities of French Guiana. Methods—This retrospective study included all patients for whom a record of a suicide attempt was documented in their medical records between 2007 and 2018 and who were treated by decentralized prevention and care centers. These centers were grouped into two zones based on their geographic location. Results—The highest suicide rates were found in the municipalities of Camopi and Trois Sauts, with 113 and 137 deaths per 100,000 inhabitants per year, respectively. The average age of suicide deaths was significantly lower in isolated inland municipalities (25 years, 95% CI: [21.42–29.36] ) than in villages closer to the coast (36 years [26.66–45.56] ). The most common methods were hanging (72%) and poisoning (18%). Similarly, the highest rate of suicide attempts was observed in remote areas, particularly Camopi and Trois Sauts, with 265 and 413 per 100,000 inhabitants per year, respectively. Here too, hanging was the most common method. Conclusion—Suicide rates in remote municipalities in French Guiana were up to eight times higher than in metropolitan France. Suicide among young people, particularly in Amerindian communities, must be better understood in order to develop context-appropriate responses.