Suicide is the second leading cause of death in the United States among adolescents and young adults ages 14 to 24 years old. School counselors are trained to identify students at risk for emotional issues and possible suicidal ideation. Yet a school counselor’s self-efficacy may affect his or her willingness to carry out a suicide risk assessment with students. A total of 200 high school counselors participated in this nonexperimental cross-sectional study. Correlation matrices and a regression analysis were used to understand how different variables contributed to counselors’ self-efficacy in conducting suicide risk assessments. Implications such as an emphasis on ethical standards, securing administrative support, crisis team planning, and increased experiential activities in graduate training are all discussed.