Objective: To determine the proportion of youth suicides in New York City from 1999 to 2002 in which antidepressants were detected at autopsy. Method: This is a medical examiner surveillance study of suicides in New York City among those younger than 18 years of age. The outcome measure is serum toxicology for antidepressants. Results: From 1999 through 2002, there were 41 individuals younger than 18 years of age among residents of New York City who committed suicide. Thirty-six (87.8%) had a serum toxicological analysis and an injury death interval of 3 days or less. There was one (2.8%) suicide in which both buproprion and sertraline were detected at the time of autopsy. Antidepressants were not detected in any of the other youth suicides. Conclusions: The detection of antidepressants at autopsy was quite rare in youth suicides in New York City from 1999 to 2002. (Contains 1 table.)