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Background: Although extensive studies on adolescent suicidal behavior have been conducted in developed countries such as the United States, little data exist on risk factors for suicide among adolescents in culturally and socially disadvantages settings, such as Jamaica. Aims: To conduct a preliminary investigation of risk factors associated with suicide ideation and attempt among youths in Western Jamaica. Methods: We conducted a cross-sectional study of 342 adolescents aged 10–19 years from 19 schools. Results: Multivariate analysis showed that a history of self-violence, violent thoughts toward others, mental health diagnoses other than depression, and a history of sexual abuse were positively associated with suicide attempt. Sexual abuse, mental health diagnoses other than depression, self-violence, and ease of access to lethal substances/weapons were positively associated with suicide ideation. Conclusions: We found a relatively high prevalence of suicide ideation and suicide attempts among adolescents living in Western Jamaica. An accurate understanding of the prevailing risk factors for suicide attempts will promote a more sympathetic approach to victims and facilitate prevention efforts.