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Background Exposure to family adversities including domestic violence, parental mental ill-health, and poverty in childhood increases the risk of self-harm and suicide attempts. However, few studies have assessed the influence of clustered family adversity and poverty trajectories throughout childhood on self-harm behaviours and suicide attempts.Methods In this population-based longitudinal study, we used data on 9,136 children from the UK Millennium Cohort study. Exposure trajectories of poverty and family adversities were characterised using group-based multi-trajectory models (age 9 months – 14 years). Multivariable logistic regression models were used to examine the association of trajectories with self-harm and suicide attempts at age 17. Population-attributable fractions were calculated to quantify the contribution of family adversity and poverty to the outcomes at the country level.Results Of 9,316 participants, 2,087 (22.4%) reported self-harm behaviours and 659 (7.1%) had made a suicide attempt. Compared with children experiencing low poverty and adversity, those exposed to persistent domestic violence and abuse (OR = 1.42, 95% CI: 1.02–1.96), persistent poor parental mental health (OR = 1.32, 95% CI: 1.07–1.62), persistent poverty (OR = 1.46, 95% CI: 1.14–1.87), and persistent both poverty and poor parental mental health (OR = 1.71, 95% CI: 1.26–2.32 were more likely to report self-harm behaviours, compared to those exposed to low levels of poverty and adversity. Similarly, those exposed to persistent domestic violence and abuse (OR = 2.06, 95% CI: 1.20–3.56), persistent poor parental mental health (OR = 2.06, 95% CI: 1.50–2.85), persistent poverty (OR = 2.75, 95% CI: 1.87–4.04) and persistent poverty with poor parental mental health (OR = 3.99, 95% CI: 2.54–6.28) were significantly more likely to report suicide attempts. Overall, we estimate that about 14.9% of self-harm behaviours and 43.8% of suicide attempts were attributable to persistent family adversities and poverty.Conclusion Children growing up with persistent exposure to family adversities and poverty are more likely to harm themselves and attempt suicide, particularly those who experience the combination of long-term poor parental mental health and persistent poverty. Early detection of children at risk and intervention to prevent long-lasting adversities are key to alleviating risky behaviours in adolescents.