Far too often, violence cuts young people’s lives short. In fact, suicide is the second leading cause of death and homicide is the third leading cause of death in young people around the globe. Even more so, young people intentionally cause nonlethal harm to themselves, with as many as one in four estimated to self-injure during adolescence. A complex interplay of biological, psychological, social, cultural, and societal factors all shapes the prevalence of the risk of injury to oneself and others. The goal of a risk assessment is not only to judge the likelihood that an individual will cause harm to themselves or others, but also to understand what is happening internally, interpersonally, and systemically that is causing such immense pain and suffering that they feel pulled to respond in these ways. Only then can an individually tailored, culturally and contextually responsive plan be put in place. Risk assessment is a high-stakes endeavor that can leave clinicians feeling unsure of how to proceed. This chapter explores the complexities of risk assessment and how procedures can be thoughtfully adapted to fit the unique characteristics and context of each young person.