Suicide is a leading cause of death among Canadian adolescents. The present practice point provides paediatricians and child health professionals with a framework for assessing the adolescent with suicidal thoughts and/or behaviours. The epidemiological context, general considerations and practical suggestions for how to approach the suicidal adolescent are reviewed. Paediatricians can and should screen youth for mental illness and significant psychosocial stressors. Early identification and treatment of mental illness are important ways in which paediatricians can assist in self-injury prevention for adolescents who are considering suicide.