This chapter examines the nature and extent of the associations between overt suicidal thoughts and behavior and various other forms of adolescent health-impairing behavior. It reviews the epidemiological data linking suicidal behavior and adolescent risk behaviors, evidence compatible with the notion of a continuum of self-destructiveness. Epidemiologic studies of self-reported risk behaviors provide empirical support for the relationship between suicidal ideation or attempts and other potentially health-compromising risk behaviors. Adolescent problem behaviors such as truancy, substance use, high-risk or early onset of sexual activity, and delinquency frequently co-occur. One likely important source of apparent association between suicidal behavior and other risk behaviors is their shared association with predisposing psychiatric conditions, such as depression, disruptive disorders, or anxiety. Much more knowledge is needed about the various developmental trajectories toward suicidality in order to inform prevention, screening, and early treatment interventions.