Introduction. This study investigated the relationship between suicidal ideation and demographic characteristics, health conditions, depression, and health care utilization patterns among adolescents. Methods. Secondary analysis of the regionally representative Canadian Community Health Survey conducted in 2000/2001 (response rate 85%). Adolescents aged 15 to 19 who reported suicidal ideation in the previous year (n = 260) were compared with their peers who did not (n = 5528). The association between suicidal ideation and socio-demographic and health characteristics were investigated. Findings. Almost three-quarters (73%) of suicidal adolescents had not spoken with any health professional about mental health issues in the preceding year. Despite the fact that 80% of suicidal adolescents had regular contact with their family doctor, only 5% had consulted with them about mental health issues. In addition to the well-known risk factors of depression and stress, suicidal ideation was highly elevated in adolescents with two or more chronic health conditions, self-reported poor health, migraines, and back pain and those whose activities were prevented by pain (P < .05). Other characteristics significantly correlated with suicidal ideation included smoking, living in single parent families, and having lower levels of social support. Conclusions. Family physicians should regularly screen for suicidal thoughts in their adolescent patients with these characteristics.