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Objective To evaluate the incidence of suicidal outcomes and risk factors for short‐ and long‐term recurrence of suicidal behavior (SB) among high‐risk borderline personality disorder (BPD) patients during a 24‐month prospective follow‐up period. Methods A multicenter prospective cohort study was designed to compare data obtained from 136 patients admitted to the emergency department for current suicidal ideation (SI) or a recent suicide attempt (SA). Subjects were clinically evaluated and monitored for a new SA or suicide. Results The incidence of a new SA was 25.63 events/100 persons‐year, and one patient died by suicide. Child sexual abuse (CSA) was the only significant predictor throughout the complete follow‐up period. The absence of prior psychiatric treatment predicts the recurrence of SB in the first 6 months of follow‐up. Patient age, poor psychosocial functioning before hospitalization, age at first SA, and having multiple suicide attempts increased risk of SB recurrence at the long‐term period (24th months). In addition, there was an interaction between CSA and poor psychosocial functioning that increased risk of SB. Conclusion The risk of recurrence was higher during the first 6 months. Risk factors at 6 and 24 months vary. These findings are important for implementing suicide strategies.