We studied 162 cases of hanging by suicide occurring in 24 coroners' jurisdictions in England within a 6-month period in 2001. Prison and psychiatric ward suicides accounted for only 6% of these. The most frequently used ligatures (ropes, belts and cable) and ligature points (beams, girders, lofts and trees) are commonly available in community settings, limiting opportunities for prevention. In only half the cases (52%) were victims fully suspended with both feet off the ground. Four per cent had also taken an overdose.