Background: Suicide among children under the age of 15 years is a leading cause of death. Aims: The aim of the current study is to identify demographic, psychosocial, and psychiatric factors associated with child suicides. Method: Using external causes of deaths recorded in the Queensland Child Death Register, a case-control study design was applied. Cases were suicides of children (10–14 years) and adolescents (15–17 years); controls were other external causes of death in the same age band. Results: Between 2004 and 2012, 149 suicides were recorded: 34 of children aged 10–14 years and 115 of adolescents aged 15–17 years. The gender asymmetry was less evident in child suicides and suicides were significantly more prevalent in indigenous children. Children residing in remote areas were significantly more likely to die by suicide than other external causes compared with children in metropolitan areas. Types of precipitating events differed between children and adolescents, with children more likely to experience family problems. Disorders usually diagnosed during infancy, childhood, and adolescence (e.g., ADHD) were significantly more common among children compared with adolescents who died by suicide. Conclusion: Psychosocial and environmental aspects of children, in addition to mental health and behavioral difficulties, are important in the understanding of suicide in this age group and in the development of targeted suicide prevention.