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Globally suicidal behavior is the third most common cause of death among patients with major depressive disorder (MDD). This study presents multi-lag tone–entropy (T–E) analysis of heart rate variability (HRV) as a screening tool for identifying MDD patients with suicidal ideation. Sixty-one ECG recordings (10 min) were acquired and analyzed from control subjects (29 CONT), 16 MDD subjects with (MDDSI+) and 16 without suicidal ideation (MDDSI−). After ECG preprocessing, tone and entropy values were calculated for multiple lags (m: 1–10). The MDDSI+ group was found to have a higher mean tone value compared to that of the MDDSI− group for lags 1–8, whereas the mean entropy value was lower in MDDSI+ than that in CONT group at all lags (1–10). Leave-one-out cross-validation tests, using a classification and regression tree (CART), obtained 94.83 % accuracy in predicting MDDSI+ subjects …