Parents, doctors, teachers, and friends may be in a position to identify children who might attempt suicide, particularly those who have had any recent change in behaviour. Children and adolescents often confide only in their peers, who must be strongly encouraged not to keep a secret that could result in the tragic death of the suicidal child. Children who express overt thoughts of suicide, such as “I wish I’d never been born” or “I’d like to go to sleep and never wake up,” are at risk, but so are children with more subtle signs, such as social withdrawal, falling grades, or parting with favourite possessions. Health care practitioners have two key roles: evaluating a suicidal child’s safety and need for hospitalization and treating underlying conditions, such as depression or substance abuse. Directly asking at-risk children about suicidal thoughts can bring out important issues that are contributing to the child’s distress. Identifying these iss ues can, in turn, lead to meaningful interventions. Crisis hot lines, offering 24-hour assistance, are available in many communities and provide ready access to a sympathetic person who can give immediate counselling and assistance in obtaining further care. Although it is difficult to prove that these services actually reduce the number of deaths from suicide, they are helpful in directing children and families to appropriate resources. This overview presents the significant findings on suicidal risk in children and adolescents. Specifically, it outlines macroscopic domains of suicidal youth such as psychosocial, sociocultural, and philosophical features. A definition of youth suicidal episodes and descriptions of their component features are offered. Risk factors involving psychopathology in the suicidal youngster and family as well as other environmental, developmental, and physiological stresses are highlighted. Directions for clinical management and empirical research are offered. Suicidal behaviour is an action intended to harm oneself and includes suicide gestures, suicide attempts, and completed suicide.