Background: To promote early intervention for youth at risk for suicide, many healthcare settings have implemented routine suicide risk screening to identify youth at risk for future suicidal behavior (true positives) from those who are not at risk (true negatives). Inevitably, screening results in false positives, where individuals screen positive for suicide risk, but do not make a future suicide attempt. An improved understanding of suicide risk associated with youth false positive screenings can better inform intervention and prevention strategies. Methods: The current study evaluated characteristics known to increase suicide risk across youth groups defined by baseline Ask Suicide-Screening Questions (ASQ) results and suicide attempts at 3-month follow-up (n=99 true positives; n=906 false positives; and n=1063 true negatives). Data were obtained from the first cohort of the Emergency Department Study for Teens at Risk for Suicide (ED-STARS) multisite prospective study involving youth aged 12-17 years from 13 U.S. pediatric emergency departments from 2015-2016. Bivariate statistics compared characteristics across groups and logistic regression was used to calculate odds ratios for baseline items that significantly differentiated true and false positive results. Results: The sample was predominantly female, White, and non-Hispanic. Youth characterized as false positives were significantly more likely to exhibit clinical symptoms associated with suicide risk compared to true negatives at baseline and 3-month follow-up. Past month mental health services, lower family, peer, and school connectedness, a history of trauma, and substance abuse were also significantly associated with false positives. Compared to true positives, youth false positives were significantly less likely to report a history of suicide ideation, and had higher social connectedness even after controlling for other significant risk factors. Discussion: False positive cases differed significantly from true negatives on a range of clinical conditions, risks, and protective factors. Findings suggest that youth with false positive results for suicide risk would benefit from further assessment and clinical follow up. An emphasis on social connectedness as a key protective factor among these high-risk youth could also be an important target for preventive intervention.