American Indian (AI) adolescents who attempt suicide are heterogeneous. A latent class analysis was used to identify subgroups of reservation-based AI adolescents with recent suicide attempts. Indicators of class membership were substance abuse and aggressive behaviors; clinical correlates of subgroup membership included risky sexual behavior and recent exposure to suicidal behavior. Three subgroups were identified, representing low, medium, and high substance use and aggressive behavior. Suicide exposure was associated with membership in the lowest risk behavior subgroup; risky sexual behavior was associated with membership the highest risk behaviors subgroup. Findings suggest a continuum of risk behaviors in reservation-based AI youth who attempt suicide.