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This systematic review assesses the effectiveness of peer-led suicide prevention programs for college students and adolescents, analyzing studies from 2019 to 2023. It compares these programs to professional training in reducing suicidal ideation and behaviors, using the Interpersonal Theory of Suicide as a framework. The review examines the impact of peer-led initiatives on thwarted belongingness, perceived burdensomeness, and acquired capability for suicide. Findings show significant improvements in support, reduced stigmatization, and enhanced suicide literacy and awareness. Key components for effective interventions include comprehensive training, mental health literacy, supportive networks, and continuous evaluation. The study highlights the potential of peer-led programs in mitigating suicide risks and offers insights for future program development. Theoretical and practical implications discussed.