ObjectiveSuicide is a leading cause of death among children and adolescents. Suicide risk screening tools can detect the risk of suicide among patients presenting to healthcare settings. The aim of this review was to describe the effectiveness of universal suicide risk screening (all patients) compared with selective screening (behavioural health patients only) in children and adolescents in emergency departments (EDs).MethodA literature search was conducted on PubMed for articles related to suicide risk screening in paediatric EDs between January 2016 and February 2022.Results8 studies met the selection criteria. The review showed that 46%–93% of patients that screened positive for suicide risk had presented with a medical concern. These patients would have been missed without universal suicide risk screening. In both selective and universal screening scenarios, use of a suicide risk screening tool was better at detecting suicide risk compared with use of presenting problem alone. Suicide risk screening was found to be acceptable without increasing length of stay in the ED.ConclusionBased on this review, using a suicide screening tool can help detect patients at risk who would otherwise have been missed.