Data from the 2019 National Youth Risk Behavior Surveillance System, consisting of 13,677 U.S. high school students, were used to investigate patterns of suicidality, with a particular focus on understanding the interplay between depression and other relevant predictors of suicidality. Through a conjunctive analysis of case configurations (CACC), results from the current study demonstrate that (1) reported suicidality clusters significantly among specific adolescent profiles, which are defined by the unique combination of variable attributes; (2) students most at risk of suicidality consistently reported depression, but students at less risk of suicidality rarely reported bullying, sexual victimization, or depression; and (3) reported depression greatly increases the risk of adolescent suicidality in some situational contexts, but can have almost no influence on the risk of suicidality in others. Current findings are discussed considering existing scholarship on adolescent suicidal behaviors and recommendations for policy and future areas of research are offered.