BACKGROUND: Suicidal ideation (SI) poses a significant global health concern, particularly among hospitalized individuals, with gaps in understanding its contributing factors in low and middle-income countries like Peru. METHODS: Using a cross-sectional design, this study examined 940 patients evaluated by the Consultation-Liaison Psychiatry Unit at a major Peruvian general hospital. Sociodemographic and clinical characteristics were assessed, employing standardized instruments such as the Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire-15 (PHQ-15), and Clinical Global Impressions (CGI). The prevalence of SI and its associations were explored through bivariate and multivariate analyses. RESULTS: The prevalence of SI was 19.7%, with notable associations found in patients experiencing moderate-to-severe depression (36.8%) and those rated as moderately to severely ill on CGI (33.2%). Multivariate analysis confirmed these associations, highlighting link with retirement (aPR = 1.53, 95% CI = 1.04-2.26, p = 0.032), clinical severity (aPR = 1.41, 95% CI = 1.22-1.63, p <
0.0001), and depressive symptoms (aPR = 2.98, 95% CI = 2.13-4.17, p <
0.0001) on SI. CONCLUSION: This study provides insights into factors associated with SI among hospitalized patients. Identifying risk factors, such as retirement, clinical severity, and depressive symptoms, underscores the need for targeted interventions to address SI within the Peruvian general hospital setting.