This systematic review explored the relationship between adolescent substance abuse and suicidality. Peer-reviewed journal articles concerned with this topic were analyzed and screened from Google Scholar and Milligan University’s online research database. While the research varied in terms of experimental design, the data indicates that adolescent substance use, suicidal ideation, and suicide attempts are positively correlated. Increases in frequency of use and lethality of substance strengthens the relationship between the variables. Findings also indicate that females and minority groups are most likely to exhibit suicidal behavior and non-suicidal forms of self-injury. The research identifies various risk factors that contribute to adolescent suicidal ideation and substance abuse. The research varied in terms of experimental design, implications for future research, and approach to treatment.