Suicide risk assessment remains a challenging task for all clinicians. Despite the vast literature on suicide, there is no consensus on how to best conduct a comprehensive suicide risk assessment. In clinical practice, various methods of assessment are employed. Some studies suggest that structured suicide assessments are less likely to miss important risk factors. Although a structured professional judgment methodology (S-RAMM) for suicide risk assessment has been recently developed, it has not received wide acceptance in clinical practice, partly because it is time consuming and it focuses mostly on chronic, non-affective, suicide risk factors. Furthermore, there is evidence that commonly assessed risk factors such as suicidal ideation and plan are not good predictors of acute suicide risk. The objective of this paper is to introduce an evidence-based, time sensitive, structured approach for the assessment of acute suicide risk that can be easily incorporated into a psychiatric interview. In this approach, in addition to assessing risk and protective factors, the clinician systematically assesses the individual's emotional reaction to distressing events. Five affective domains that are associated with suicide are examined including: humiliation/shame, anger, guilt, depression, and emotional detachment. Specific guidelines and questions are provided to ensure a structured and systematic evaluation. Case studies will be used to illustrate the application of this model in diverse clinical settings.