Background No recent cross-country examinations for youth suicide trends and methods for Europe were found. Aim The aim of the study is to specify differences in suicide rates, trends and methods used among 15–24 years olds by gender across 15 European countries. Method Data for 14,738 suicide cases in the age group 15–24 in 2000–2004/5 were obtained and analysed. Results Suicide rates ranged 5.5–35.1 for males and 1.3–8.5 for females. Statistically significant decline since 2000 was observed in Germany, Scotland, Spain, and England for males and in Ireland for females. Hanging was most frequently used for both genders, followed by jumping and use of a moving object for males and jumping and poisoning by drugs for females. Male suicides had a higher risk than females of using firearms and hanging and lower risk of poisoning by drugs and jumping. There were large differences between single countries. Limitations The limitations of the study are the small numbers of specific suicide methods in some countries as well as the re-categorisation of ICD-9 codes into ICD-10 in England, Ireland and Portugal. Further, the use of suicides (X60–X84) without events of undetermined deaths (Y10–Y34) continues to be problematic considering the possibility of “hidden suicides”. Conclusions The present study shows that suicide rates among young males are decreasing since 2000 in several European countries. Analysis of suicide methods confirms that there is a very high proportion of hanging in youths, which is extremely difficult to restrict. However, besides hanging there are also high rates of preventable suicide methods and reducing the availability of means should be one of the goals of suicide prevention.