Suicide is a public health problem. Its etiology is multifactorial, and drug use appears in it. The objective of this study was to determine the prevalence of suicidal ideation and its relation to drug use, depression, impulsiveness and self-esteem in the state of Campeche. The study was cross-sectional, analytical with a probabilistic sample of 2386 secondary students. Prevalence of suicidal ideation was 13.1% (15.5% for women). There were significant associations between smoking, heavy drinking, and use of other drugs (inhalants, marijuana, cocaine, crack, and strikeouts) in the last month and suicidal ideation. Drug use, associated with depression and impulsivity predicted it in 44.2%. A significant association between drug use and suicidal ideation was found; depression and impulsivity are factors that enhance and increase the prediction of suicidal ideation.