Aripiprazole augmentation therapy is considered to be effective in the treatment of depression. However, there are few reports of a correlation between aripiprazole and the suicide events. These cases most often involved patients with schizophrenia or bipolar disorder, few depressive only. More attention was necessary on whether the aripiprazole augmentation is effective on the suicide prevention especially major depressive patients. Herein we present a case of an elderly female with refractory major depression. Although she had rapid remission under aripiprazole augmentation therapy, the relapse of depression happened soon even with maintaining medication. The patient committed suicide at last. Suicide prevention is one of the main outcomes when treating depression. There is much we do not know regarding the correlation of aripiprazole use and suicide events especially in major depressive cases especially elderly patients. Future randomized, controlled studies may help to provide more clarity regarding the efficacy of aripiprazole augmentation in maintenance treatment of depression and the prevention of suicide.