Objective To explore the effect of stratified suicide risk screening and interventions for neurological patients. Methods Four divisions of the department of neurology were randomly divided into two groups, with 2 divisions in each group. Patients were screened for suicide risk using the Patient Health Questionnaire 9 （PHQ-9）, and those with PHQ-9 score ≥15 or positive item 9 were enrolled in this study. The control group of 147 patients were given routine suicide prevention in the department of neurology, while their counterparts in the intervention group (n=138) were screened again using the Columbia-Suicide Severity Rating Scale, and those at high-risk of suicide received comprehensive interventions. Results The total PHQ-9 score and rate of positive item 9 in the intervention group were significantly lower than the control group at discharge (P<0.01 for both). The frequency of suicide ideation, lasting duration, and controllability in the intervention group were significantly lower after the intervention compared with the baseline values (P<0.01 for all). Conclusion Adding secondary screening and implementing targeted preventive interventions to neurological patients at high-risk suicide can effectively reduce the suicide risk.