Bipolar disorder carries one of the highest lifetime risks of suicide, concentrated in mixed states, early post-hospital periods, and times of role loss or sleep disruption. Suicide Risk in Bipolar Disorder focuses on phase-accurate assessment and rapid stabilization. Risk looks different across poles: in depression, psychic pain, hopelessness, and insomnia dominate; in hypomania/mania, impulsivity, grandiosity, substance use, and reduced need for sleep shorten the gap between ideation and action; mixed features combine agitation with despair—the perfect storm. We detail assessment that captures polarity, cycling speed, sleep timing, alcohol/stimulant use, access to lethal means, and prior attempts; use tools as prompts, not substitutes for clinical judgment. Treatment centers on mood stabilization first: optimize lithium where appropriate (suicide-protective evidence), valproate/lamotrigine or atypical antipsychotics tailored to profile; treat insomnia early; and avoid antidepressant monotherapy in bipolar I or mixed features. Adjuncts for acute risk include rapid-acting interventions under protocolized settings. Psychotherapies (CBT-BD, IPSRT, FFT) provide rhythm repair, relapse prevention, and family collaboration; brief DBT skills help with urges and conflict. Build social safety: means safety, contact maps, and peer supports. Equity lens: language access, tele options for rural areas, and cost-aware regimens. Operations matter: coordinated specialty care, post-discharge calls within 72 hours, and single-plan communication between inpatient, outpatient, and family. Track what predicts tomorrow’s risk—sleep regularity, stimulant use, agitation—and what builds a future: role steps, connection minutes, and hope statements. With structure and speed, Suicide Risk in Bipolar Disorder, practical insights from a bipolar suicide prevention conference, and evidence-based lithium strategies can bend risk downward.