Objective: Chronic medical problems might amplify suicide risk in later life. Feelings of happiness may reduce this risk. We tested the hypothesis that happiness attenuates the association between number of self-reported chronic diseases and suicidal distress. Methods: A sample of 1,801 depressed, primary care patients, 60 years of age or older, entering a clinical trial, were assessed for the presence of positive emotion, suicidal distress and self-reported chronic medical problems. Results: Chronic medical problems are associated with suicide ideation and, as hypothesized, happiness attenuates the relationship between self-reported diseases and suicidal distress. Conclusions: Decreased risk for distressing thoughts of suicide in the context of medical illness is predicted by the presence of positive emotions. Our results suggest that treatments designed to help older primary care patients identify sources of joy and enhance happiness might decrease suicide risk.