Suicide is the leading cause of death in Hong Kong SAR for the youth aged 15?24. This study examined the prevalence of suicidality among secondary school students in Hong Kong using a representative, territory-wide sample of 2,586 students. Suicidal behaviors can be conceptualized as a spectrum of self-destructive behaviors. Cumulative logit model analysis indicated that a range of factors, such as unhappy family life, were associated with increasing levels of suicidality. Use of illicit drugs, inhalants, and tobacco differentiated attempters from ideators. The implications of the research findings are discussed.