Suicide is a significant global public health concern, particularly among adolescents, with substantial implications for economies, societies and individuals' mental well-being. Understanding its patterns and intention and psychosocial determinants in a given context can suggest potential intervention points. This population-based cross-sectional study aimed to document suicidal ideas, behaviors and intensity among youths aged 14 to 25 in the Nairobi metropolitan area and associated socio-economic position, demographic indicators and potential intervention points. A diverse sample of 1,972 participants was recruited from urban and peri-urban settings within the Nairobi metropolitan area. Data analysis included descriptive statistics, chi-square tests and logistic regression. Our findings confirm a high prevalence of suicidal ideas and behavior in the youth (19.9% and 3.6%, respectively), with very few significant differences between the urban and peri-urban areas. The severity of suicidal ideation and behavior reported methods and reasons, and the socio-demographic profile of participants, point to multiple potential intervention targets. These findings ought to be used to design, manage and evaluate suicide prevention programs.