OBJECTIVE Youth suicide and suicidality are significant public health concerns, with rates continuing to rise. Suicidality can be chronic, requiring ongoing management and support. The current article presents a case study exploring the chronicity of suicidality, mental health workforce challenges, and the critical role of primary care in youth suicide prevention. METHODS Evidence-based practices for how primary care providers can screen, assess, intervene, and follow up with youth experiencing suicidality and their families are presented. RESULTS Recommended solutions to address the suicide prevention gaps in primary care, including workforce education and training, care integration, and expansion of care delivery models, are offered. CONCLUSIONS Youth suicide prevention is the responsibility of all care providers and requires a coordinated approach across a child's entire system of care. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].