In the process of psychiatric consultation, the issue of suicidal thought, planning and attempt carry high significance in terms of management and prognosis. However, both these terms are not well understood by many mental health professionals and often the residents fail to detect whether the patient has expressed suicidal thoughts or it was merely a death wish. Many psychiatric admissions are done on the basis of seriousness of the issue of suicidality and that both the expression of death wish as well as suicidal thoughts is held in the same magnitude in terms of its significance. Freud has described this as "thanatos" which is a death drive representing the organic need to return to lifelessness and stasis, the ultimate calm of lifeless non-conflict attributing all aggressive and destructive activity to this notion. Death wish is a general expression when some life events assume severe proportions and start taking their toll on the mental health or it is a casual cultural expression when some social hardships cause trouble. This is a review article.