Rates of self-injurious thoughts and behaviors are elevated among autistic youth, yet research is limited to caregiver report or single-item questionnaires. Investigation of specific suicidal thoughts, triggers, and disclosure is needed to improve risk assessment and interventions. The current study characterized self-injurious thoughts and behaviors in a sample of autistic youth without intellectual disability presenting for outpatient psychological services. The Columbia-Suicide Severity Rating Scale and qualitative follow-up questions were administered to 103 autistic youth (10-17 years of age). Most autistic youth (n = 86; 83.5%) reported lifetime suicidal thoughts. Suicide thought content most commonly included abstract thoughts of dying/suicide (n = 20; 23.3%) and death by cutting (n = 13; 15.1%). Half of youth experiencing suicidal thoughts (n = 43; 50.0%) denied disclosure to their caregiver. Nearly one in four youth attempted suicide (n = 25; 24.3%), and some youth (n = 16; 15.5%) sought help from caregivers to prevent an attempt. Sadness/depression and bullying/teasing were the most commonly reported triggers of suicidal behaviors. Among autistic youth with lifetime nonsuicidal self-injury (n = 52; 50.5%), head hitting (n = 28; 45.2%) and cutting (n = 20; 32.3%) were the most reported types. Findings underscore the importance of targeted prevention and intervention to address self-injurious thoughts and behaviors in autistic youth and continued research to understand barriers and modifiable factors to facilitate self-injurious thoughts and behaviors disclosure.