The number of adolescent deaths from suicide in the United States has increased dramatically during the past few decades. Firearms, which are used in 67 percent of suicides, are the leading cause of death for males and females who commit suicide. Although no specific tests are capable of identifying suicidal persons, there are specific risk factors. Adolescents at higher risk of suicide commonly have a history of depression, a previous suicide attempt, a family history of psychiatric disorders, family disruption, and certain chronic and debilitating physical disorders or psychiatric illness. Alcohol use and alcoholism indicate high risk for suicide. Psychosocial problems and stresses, such as conflict with parents, breakup of a relationship, school difficulties or failure, legal difficulties, social isolation, and physical ailments commonly are reported or observed in youth who attempt suicide. Pediatricians with adolescent patients with symptoms of depression should ask their patients about suicidal ideation, and an estimation of the degree of suicidal intent should be made. Symptoms of depression are described in this policy statement. Pediatricians must inform the appropriate persons when they believe an adolescent is at risk of suicide. In all cases, determination of the sequence of events that preceded the threat, identification of current problems and conflict, and assessment of the degree of suicidal intent must be completed. Pediatricians should work closely with families and health care professionals involved in the management and follow-up of youth who are at risk or have attempted suicide. Also, pediatricians should advocate for benefit packages in health insurance plans to ensure that adolescents have access to preventive and therapeutic mental health services that adequately cover the treatment of clinically significant mental health disorders. 28 references and a table that lists examples of adolescents at low, moderate, and high risk for suicide