Abstract: BACKGROUND: Women Veterans are at increased risk for both substance use and suicidality, both of which can contribute to early morbidity and mortality. AIMS: This study aimed to examine the impact of substance use on suicidality among women Veterans compared to their peers, and how this relationship might be moderated by access to care. METHODS: This study utilized data from the 2015 to 2019 National Surveys on Drug Use and Health (NSDUH) administered by the Substance Abuse and Mental Health Services Administration (SAMHSA) (n = 131,344). A series of binary logistic regression analyses was used to examine the relationship between substance use and suicidality, adjusted for demographic factors and stratified by sex and Veteran status. RESULTS: Women Veterans were at increased odds of suicidality compared to their peers. In women Veterans, only lifetime non-prescribed prescription opioid use (aOR = 1.99 [1.04-3.79], p = .038) and lifetime cocaine use (aOR = 1.74 [1.10 = 2.74], p = .018) increased the odds of past-year suicidal ideation. Past-year cannabis use disorder, but not combined drug use disorders, increased the odds of suicidal ideation in women Veterans (aOR = 3.93 [1.21-13.81], p = .033). Lifetime cannabis use (aOR = 2.02 [1.03-3.96], p = .040), lifetime cocaine use (aOR=2.24, 1.20-4.05, p = .011), and lifetime stimulant use (aOR = 1.87 [1.05-3.33], p = .034) increased the odds of past-year suicide plans among women Veterans. CONCLUSIONS: Women Veterans are at increased risk for suicidality, and substance use may predict suicidality in this population. Psychiatric nurses can be instrumental in ensuring timely access to care for women Veterans, underscoring this study's clinical relevance.