Background Schools appear an obvious place to deliver suicide prevention interventions for children and adolescents. The complexity of suicide interventions lead to a paucity of good quality evidence. An alternate approach of information gathering is needed to identify and collate evidence from existing interventions. Scope We completed a realist review of school‐based suicide interventions. This is a novel method of understanding complex interventions that uses an iterative approach. In this review, we attempt to clarify and lay out what type of suicide intervention programme might be useful in schools, based on the local needs and context. Conclusion It is possible to develop and implement an evidence‐based suicide intervention in schools by understanding the different processes that can contribute to success or failure of these interventions in a real‐world setting.