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Objective: Increasing evidence suggests a crucial rȏle of C-reactive protein (CRP) in the pathological mechanisms of suicide. Whether CRP levels may be associated with suicidal ideation (SI) among patients with treatment-resistant depression (TRD) remains unclear. In this study, we intended to explore the relation between TRD and SI. Methods: Totally 36 patients with TRD and SI, 24 with TRD without SI, and 32 healthy controls were enrolled in the present study. SI was defined based on scores of ≥ 2 at the 17-item Hamilton Depression Rating Scale item 3. Fasting serum CRP levels were also measured. Results: The generalized linear model with gamma log link demonstrated that patients with TRD and SI had significantly higher CRP levels (p < 0.05) than the control group after adjusting for age, sex, and body mass index. Conclusion: Patients with TRD and SI, but not those without SI, were associated with increased CRP levels. Whether CRP may be a predictor of further suicidal risk among such high-risk patients would need further investigation.