Suicide of an individual could leave devastating consequences for family, friends, relatives, and society. Suicide could be considered a serious concern and issue to public health, especially among adolescents. The purpose of the study was to examine associations of suicide ideation with attitudes toward suicide (ATS), quality of life (QOL), and attitudes toward death and dying (ADD) in high school seniors. The participants were conveniently sampled and consisted of 1,247 high school senior students from China, South Korea, Thailand, and Vietnam. The survey found that 21.7% of the Chinese, 20.9% of the Korean, 16.8% of the Thai, and 26.3% of the Vietnamese participants exhibited suicide ideation. The analysis revealed that student suicide ideation was significantly associated with ATS, QOL, and sustained elements of depression during the past 12 months in all four countries. In addition, there were statistically differences among the Chinese, Korean, Thai, and Vietnamese students in QOL, ATS, and ADD. The analysis determined that there were certain predictive factors for suicide ideation in the participants. The impact of these findings could extend to professional roles within the school system including curricula and services. Administrators, faculty, or social workers could gain a better understanding of the current suicide ideation phenomenon and help raise awareness to reduce potential suicide attempts among high school students in these Asian countries.