The developmental progression before suicide death is multi-directional and reversible, with differing influencing factors at each stage. However, previous research on this topic is very limited. This study aims to delve into the transitional features of adolescent suicide progression and associated factors. A longitudinal survey of 1,407 adolescents (Mage = 14.64, SD = 0.73) was conducted over six months. Latent transition analysis and logistic regression were employed to explore the transitions in the suicide process and examine the effects of psychache, childhood maltreatment, regulatory emotional self-efficacy, and demographic factors on the transition patterns. Adolescents could be categorized into three subgroups at two time points: Non-Ideators (T1: 83.7 %, T2: 86.7 %), Ideators (T1: 12.0 %, T2: 9.1 %), and Attempters (T1: 4.3 %, T2: 4.2 %). Non-Ideators demonstrated the highest stability, while Ideators and Attempters were more likely to transition to other groups. Psychache positively predicted the emergence of suicide ideation and its transition to suicide attempt, and negatively predicted the diminishment of suicide ideation. Childhood maltreatment positively predicted the transition from suicide ideation to attempt. Regulatory emotional self-efficacy negatively predicted the emergence of suicide ideation. Findings enhance the understanding of the transitional patterns of adolescent suicidality and influencing factors at different stages. More targeted prevention and intervention programs for adolescents’ suicidal thoughts and behaviors can be developed accordingly.