Suicidal behavior in children and youth continues to be a major public health problem in the United States. School personnel have a legal and ethical obligation to recognize and respond to the mental health needs of their students and to take steps to ensure their safety. In this exploratory study, suicide risk assessment practices of three large school districts were examined. More than 3,400 suicide risk assessments were conducted in these districts during the 3 years considered. The results indicate that all three districts have implemented suicide prevention programs that include risk-assessment practices in an effort to reduce suicidality. Suicides risk assessments were conducted with at least one child in each grade from kindergarten through 12th in each district, occurring most frequently at the middle school level. Differences by gender were noted in terms of level of risk and hospitalizations, but no significant differences were observed based on race/ethnicity. These risk assessment efforts of these three districts appear to be promising in preventing suicides: none of the students who were assessed went on to commit suicide. Implications for school-based practices and training are discussed.