Adolescents and youth who have entered residential care present a number of risk factors for suicidal behavior. However, little research has been conducted in Spain with the aim of determining the extent of the problem of suicidal behavior in the context of youth residential care. The sample comprised 185 adolescents aged between 12 and 18 years (M = 15.41, SD = 1.58; 49.7% male, 49.2% female, and 1.1% non-binary) and 225 direct care professionals (Mage = 34.58, SD = 13.72). We found a high rate of suicidal behavior and non-suicidal self-injury, and only a third of young people who had thoughts about suicide had sought help with this. Among direct care professionals, there was a perceived lack of knowledge with respect to recognizing and managing suicide risk behavior. Adolescents in residential care are a risk population that should be targeted with specific interventions aimed at preventing suicidal behavior. Training for professionals is also needed. One way of addressing this need for increased knowledge and competence would be through the implementation of gatekeeper suicide prevention programs.