Youth suicidality is a significant public health problem in the U.S. and worldwide, leading to devastating social, emotional, and economic consequences. While the ability to accurately predict and prevent suicidal behavior is not absolute and the universal effectiveness of suicide screening and assessment is debated in the literature, pediatric primary care is the ideal environment in which to identify risk and promote protective factors to reduce youth suicide. Pediatric primary care settings are designed to provide continuous and comprehensive health care services to children and adolescents and are the port of entry into many specialty medical and mental health settings. This chapter will identify the benefits and challenges of conducting suicide assessment in pediatric primary care, discuss the risk and protective factors for youth who present in primary care, and outline characteristics and use of various suicide assessment and screening tools that can be applied to this population.