Music and non-suicidal self injury (NSSI) are both of extraordinary importance for adolescents with respect to expressing emotions, and demonstrating protest. Nevertheless, little is known about the interrelation between these phenomena, in particular about the function of music in the context of NSSI. The aim of our study was to investigate the connections between music and auto-aggressive behaviour and suicidality in adolescents. We developed a specific questionnaire for this purpose, which was used together with a self-reporting depression inventory in 40 subjects in a child and adolescent psychiatric clinic. We enrolled inpatients between 13 and 18 years who had presented with NSSI and/or suicidality during the last three months. Music proved to be very important to the patients and seemed to have an emotionally elevating function. Moreover, music was in some cases an integral part of the NSSI-scenario, but also was used to inhibit autoaggressive tendencies. In a qualitative analysis, it could be demonstrated that music and lyrics are associated with affect regulation, anti-dissociation and interpersonal influence. Music seems to fulfil similar self-regulatory functions as have been described for NSSI and can thus be considered, as a substitute to have a protective effect. There were no indications that specific music preferences are directly linked to NSSI or suicidality.