Objectives To understand the differences between self-harm behaviors with and without suicidal ideation among psychological aids hotline callers. Methods All calls to Beijing Psychological Aids Hotline during December 2002 to December 2008 in which callers reported history of self-harm were included in the study. During receiving the calls， hotline operators asked the callers about the specific situation of selfharm behaviors. According to the presence or absence of suicidal ideation， the self-harm callers were divided into two groups to compare. Results Among the 4 423 callers with self-harm history， 2 731（ 61.7%） of them had suicidal ideations. Multivariate logistic regression indicated that the self-harm method， purpose and whether being treated in hospital were associated with suicidal ideation among self-harm callers. Self-harm callers who are female（ AOR=1.17）， who sought for medical treatment after self-harm（ AOR=1.85）， choosing to fall， taking therapeutic drugs or other poisons（ AOR=1.77，1.48，1.71） were more likely to have suicidal ideation. People engaging self-harm by cutting wrist or the rope（ AOR=0.72） and for the purpose of punishing others（ AOR=0.20） were less likely to have suicidal ideation. Conclusions Hotline callers' self-harm behavior with or without suicidal ideation differs in self-harm characteristics and related factors， but there are also many similarities. Suicide prevention measures should not overlook those self-harm without clear suicidal ideation.