The aim of this study was to compare the regional difference of death from intentional self-harm. The analysis was based on data of intentional self-harm deaths (31,450) from the 2010-2011 vital statistics of Korea. The suicide rate (per 100,000 population) was 46.2 in male and 22.3 in female. Gender ratio (male / female) of suicide rate was 2.07, and Jeju province had the lowest gender ratio (1.82), and Chungbuk province had the highest gender ratio (2.42). In the age-gender standardized death rate (per 100,000) of self-harm by region, the highest suicide rate was observed in Gangwon province (44.8) and Chungnam province (44.3), and the lowest in Seoul metropolitan city (28.9) and Ulsan metropolitan city (29.2). There was a significant increase in the rate of suicide in city areas (odds ratio: 1.11, 95% CI: 1.08-1.13), county areas (1.62, 1.56-1.67) as compared with the rate of suicide in metropolitan areas. The commonest methods of suicide were hanging (53.7 percent), self-poisoning by pesticides (16.8 percent) and jumping from a height (14.3 percent). The methods used for suicide differed between rural (county) and urban areas (metropolitan city and city). In county areas, 43 percent of suicides used pesticides as compared to only 7-18 percent of those in urban areas. In urban areas, jumping was more common (13-17 percent vs. 6 percent). There were no difference in hanging between urban and rural areas. The odds ratio of death by pesticides was 9.86 in rural areas compared with death rate of metropolitan areas. The odds ratio of death by jumping was 0.59 in rural compared with death rate of metropolitan areas.