This paper presents a clinical case report & provides a review of the available literature on fetal alcohol syndrome & the fetal alcohol spectrum disorders & suicidality to highlight important implications for providers. Almost 6% of adolescents evaluated by the fetal alcohol spectrum disorders diagnostic clinic at the Alaska Native Medical Center had been seen for self-harm related consultations. Persons with fetal alcohol syndrome & the fetal alcohol spectrum disorders demonstrate characteristics or features commonly thought to be risk factors for suicide. They may experience mental health problems, including suicide ideation & attempts, over the course of their life time. (18 refs.)