This study describes the prevalence of suicide ideation in 109 Global School-based Health Surveys (GSHS) conducted from 2003-2010 representing 49 different countries and 266,694 school-attending students aged 13-15 years primarily living in developing areas of the World. Prevalence of suicide ideation varied widely among and between countries, regions, and by gender, with an overall mean prevalence of suicide ideation of 15.3%. When grouped by region, Africa had the highest percentage of participants reporting suicide ideation (19.8%). The wide variability in the prevalence of suicide ideation found in this study confirms that school psychologists and counselors must be prepared to deal with the unique needs and characteristics of the specific populations of youth they serve, as the needs are likely to vary substantially from locality to locality, and country to country.