Preventing, managing, and understanding suicide depends upon adequate assessment and identification, but medicine has been challenged by a lack of clarity and standardized approaches in assessing suicidality. Such issues undermine confidence in research, clinical practice, and drug safety efforts. The Columbia-Suicide Severity Rating Scale (C-SSRS), frequently recommended by the FDA and other international agencies, is being used broadly in clinical and research domains in the assessment of suicidality with adolescents and adults across a wide range of areas. Although it is low-burden, it assesses the full-range of ideation and behavior, as well as intensity of ideation. The C-SSRS is not only useful in clinical settings in developing next steps, reducing unnecessary burden and referrals, and reducing false positives, but it is also used in clinical trials to establish inclusion/exclusion criteria and collect safety and treatment outcome data. Prospective, systematic measurement of suicidality more clearly delineates the relationship between suicidal adverse events and medications, provides more meaningful research data, improves aggregated analyses, and better informs risk/benefit analyses.  In clinical practice, it helps to optimize safety and management and better track improvement or worsening of suicidality.