BACKGROUND After an epidemic rise in Australian young male suicide rates over the 1970s to 1990s, the period following the implementation of the original National Youth Suicide Prevention Strategy (NYSPS) in 1995 saw substantial declines in suicide in young men. OBJECTIVE To investigate whether areas with locally targeted suicide prevention activity implemented after 1995 experienced lower rates of young adult suicide, compared with areas without such activity. METHODS Localities with or without identified suicide prevention activity were compared during the period of the NYSPS implementation (1995-1998) and a period subsequent to implementation (1999-2002) to establish whether annual average suicide rates were lower and declined more quickly in areas with suicide prevention activity over the period 1995-2002. RESULTS Male suicide rates were lower in areas with targeted suicide prevention activity (and higher levels of funding) compared with areas receiving no activity both during (RR = 0.89, 95% CI 0.80-0.99, P = 0.030) and after (RR = 0.86, 95% CI 0.77-0.96, P = 0.009) implementation, with rates declining faster in areas with targeted activity than in those without (13% v. 10% decline). However, these differences were reduced and were no longer statistically significant following adjustment for sociodemographic variables. There was no difference in female suicide rates between areas with or without targeted suicide prevention activity. CONCLUSIONS There was little discernible impact on suicide rates in areas receiving locally targeted suicide prevention activities in the period following the NYSPS.