Suicide rates are increasing rapidly among Black children and adolescents, calling for novel approaches to understanding their unique risk factors. The Structural Racism and Suicide Prevention Systems Framework offers a new culturally responsive theory that structural racism is an underlying mechanism for disparities in suicide among ethnoracial marginalized youth. Thus, a deeper analysis of the intersection of racism and systems to better understand suicide risk and create more effective targeted interventions for Black youth is imperative. The current systematic review comprehensively evaluated and synthesized the empirical literature regarding the relationship between structural racism and suicide risk among Black youth. 17 studies from 3 database searches, published between 2013 and 2024 are presented. Results revealed a positive relationship between structural racism and suicidal thoughts and behaviors among Black youth. Systems that particularly facilitate the perpetration of racism toward Black youth include schools, criminal justice, and income inequality. Findings serve as a call to action to incorporate more socioecological models into suicide prevention research focused on Black youth. Understanding the depth and scope of how racism contributes to suicide risk provides key targets for prevention and intervention strategies that are specific to individuals belonging to this group at disparate risk for suicide.