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Primary care providers (PCPs) usually do not explore patient suicidality during routine visits. Factors that predict PCP attitudes toward the assessment and treatment of suicidality were examined via an online survey of 195 practicing PCPs affiliated with medical schools in the United States. PCPs who perceived themselves as competent to work with suicidal patients were more willing to assess and more willing to treat suicidal patients, with the perception of competency fully explaining the relationship between training and willingness to treat. Female gender predicted lower self-perceived competency, while in-office access to professional mental health (MH) consultation predicted greater self-perceived competency. Higher self-perceived general competence predicted lower subjective valuation of access to MH consultation. Multiple linear regression analysis indicated a three-way interaction between training, gender, and valuation of MH consultation as predictors of perceived competency, with training generally being associated with greater perceived competency to treat suicidality. Relative to their male counterparts, female PCPs have lower confidence in assessing and treating suicidality. Perceived competence in risk assessment should be given more attention in medical training because of its role in PCPs’ willingness to treat suicidality.