Background <p>Depression in adolescents often co-occurs with suicidal ideation and behaviors. In clinical practice, many adolescents with depression report prominent somatic complaints, yet the relevance of these somatic symptoms to different forms of suicide risk has received limited attention.</p> Objective <p>This study explored the network among somatic symptoms, depressive symptom dimensions, and three suicide-related indicators—passive suicidal ideation (PSI), active suicidal ideation (ASI), and suicide attempts (SA)—in a sample of treatment-naïve adolescents presenting with first-episode depression.</p> Methods <p>This cross-sectional study included 414 adolescents in China. Symptom data were collected using the Hamilton Depression Rating Scale (HAMD-17), Patient Health Questionnaire-15 (PHQ-15), Beck Scale for Suicide Ideation (BSI), and Columbia-Suicide Severity Rating Scale (C-SSRS). A Mixed Graphical Model estimated network structure, node centrality, and predictability for depressive and somatic symptoms and suicide risk indicators.</p> Results <p>Cardiopulmonary and pain symptoms occupied central positions within the symptom network. Cardiopulmonary symptoms were weakly connected to passive suicidal ideation, whereas pain symptoms showed weak associations with suicide attempt status.</p> Conclusions <p>This cross-sectional symptom network describes how somatic symptom dimensions—particularly cardiopulmonary and pain symptoms—are positioned within a symptom network encompassing depressive symptoms and suicide risk indicators in adolescents with depression. Rather than supporting causal interpretations, these findings highlight the utility of symptom networks as a descriptive framework for organizing somatic symptoms within heterogeneous suicide risk profiles and for informing future longitudinal investigations.</p> Clinical trial number <p>Not applicable.</p>