Globally, suicide is a major public health issue. Suicide is the first or second reason for death among college and university students. The suicide rate among university students is relatively high in Malaysia. Numerous risk factors exacerbate suicidal ideation. Therefore, it is critical to gain as much insight as possible into the risk factors for suicidal ideation among university students and prioritize them based on the importance level. Therefore, students with a high risk for suicide can be identified, and earlier precautions can be taken to assist the students. In this paper, 18 determinants of suicidal ideation were discovered through the systematic literature review, and these factors were then ranked according to the seriousness using the TOPSIS method. The results showed that previous suicide attempts, mental disorders, and negative life events were the most influential factors leading to suicide. In contrast, gender and the residential area had the least impact. The result enables the government, relevant stakeholders, and policymakers to develop comprehensive multisectoral strategies that can prevent suicide effectively.