Donald E Greydanus1,2, Roger W Apple31Pediatrics and Human Development; College of Human Medicine, Michigan State University, East Lansing, MI, USA; 2Kalamazoo Center for Medical Studies, Michigan State University, Kalamazoo, MI, USA; 3Psychological Evaluation and Consultation Services, Kalamazoo Regional Educational Service Agency, Portage, MI, USAAbstract: Deliberate self-harm (DSH) is a common though often hidden condition in children and adolescents that may result in suicide. This discussion covers several aspects of DSH including its prevalence, etiology, and management. The relationships of DSH to body dissatisfaction and suicide are specifically considered. Even though most cases of DSH do not end in overt suicide, DSH reflects that potential underlying psychological pathophysiology, and likelihood of eventual death from self-murder, cannot always be predicted or prevented. It is important to take all acts of DSH as serious, and to offer comprehensive management to prevent future acts of DSH and potential suicide.Keywords: deliberate self-harm, body dissatisfaction, suicide risk, children, adolescents, etiology, management