This study examined relations between suicidal behavior history (i.e., no suicidality, suicidal ideation, single attempters, and multiple attempters) and psychiatric functioning. Adolescents, aged 12-17, admitted to an inpatient psychiatric unit, were categorized by suicidal behavior history based on self- and clinician-report data. Groups were examined for differences in suicidal ideation and psychiatric diagnosis. Severity of suicidal ideation increased with severity of suicidal behavior history. Females were disproportionately represented among multiple attempters. Multiple attempters were more likely to be diagnosed with at least one externalizing disorder, particularly substance use disorders, and to have more than one comorbid diagnosis than adolescents with no suicidal behavior or a history of ideation only. Clinicians should be alerted to the particularly high-risk nature of adolescents with multiple suicide attempts.