Suicide is a leading cause of death among youth in the United States, making emergency departments (EDs) vital for identifying at-risk individuals and initiating preventive measures. Key strategies for addressing suicide risk in the ED include creating personalized safety plans and providing counseling to limit access to lethal means. This article reviews evidence supporting the effectiveness of safety planning for youth and proposes a practical framework for its implementation. It discusses methods to enhance the delivery of safety planning and lethal means counseling, such as establishing clinical pathways, training staff, improving reimbursement processes, and integrating resources into electronic medical records. The article also highlights new innovations designed to expand the reach of safety plan interventions within the ED.