On average, approximately 45% of individuals who die by suicide have seen their primary care provider (PCP) within the month before their death. In some states, this rate reaches as high as 75%. PCPs are often a primary contact for patients who may be at risk for suicide, homicide, nonsuicidal self-injury (NSSI), and abuse or neglect. This chapter will discuss how safety and risk assessment can be used and adapted to the primary care (PC) setting. This will include risk assessment for suicide and homicide and assessing for self-injurious behaviors, abuse, and neglect. The chapter will also discuss how PCPs can utilize clinical decision-making skills to select appropriate interventions for at-risk individuals, including safety planning, means restriction, and hospitalization. Considerations for PCPs with and without access to behavioral health (BH) providers will be highlighted, as well as cultural considerations when working with special populations. This chapter will provide practical guidance and real-world examples, empowering physicians with the tools to succeed.