Research regarding youth involvement in physical fighting and suicidal ideation has been primarily conducted in western countries, such as the U.S., and limited information is available on this subject in sub-Saharan Africa. This study used data from the Global School-Based Student Health Survey (GSHS) to analyze the prevalence and correlates (i.e., bullying victimization, loneliness, having no friends, sadness, alcohol use, and drug use) of physical fighting and suicidal ideation among students, both boys and girls in Uganda. In this study, 10.1% of urban students and 15.2% of rural students reported engaging in both physical fighting and suicidal ideation. Rural students overall have a higher prevalence of physical fighting, being bullied, suicidal ideation, alcohol use and drug use when compared to urban students. Other risk factors vary among boys and girls in urban and rural settings. Gender and urban/rural differences indicate that interventions among boys and girls and urban and rural students should be adapted to address the needs of the specific groups.