Threat assessment is a violence prevention strategy used to investigate and respond to threats to harm others. In 2013, Virginia mandated the use of threat assessment teams for threats to self and to others, effectively subsuming suicide assessment with threat assessment and raising questions about the distinction between the two practices. In a statewide sample of 2,861 cases from 926 schools, there were more threats to self (60%) than others (35%), with only 5% involving threats to both self and others. Threats to self were more likely to be made by females (odds ratio [OR] = 3.38) and students with fewer prior disciplinary actions (OR = 0.48). Threats to self were much less likely to involve a weapon (OR = 0.07), but more likely to be attempted (OR = 1.50) and result in mental health services (OR = 2.96). They were much less likely to result in out-of-school suspensions (OR = 0.07), legal action (OR = 0.17), and/or changes in placement (OR = 0.53). Overall, these findings support a clear distinction between suicide and threat assessment.