The gender paradox of suicidal behavior refers to the consistent epidemiological finding that women report higher rates of suicidal ideation and non-fatal suicidal behavior, whereas men exhibit substantially higher suicide mortality. Although this paradox has been documented globally, its manifestation varies considerably across European regions. Eastern European countries, particularly post-Soviet states, demonstrate exceptionally high male suicide rates and wider gender gaps compared with Western Europe. This review examines the gender paradox of suicide from a comparative East–West European perspective, focusing on epidemiological patterns, sociocultural determinants, alcohol-related harm, economic transitions, mental health systems, and gender norms. Evidence suggests that the East–West divide reflects differences in hazardous alcohol consumption, socioeconomic instability, masculinity norms, healthcare access, and family structures. The review also discusses methodological limitations in crossnational comparisons and outlines implications for suicide prevention policy. Keywords: suicide, gender paradox, Eastern Europe, Western Europe.