Over the last decade the internet has become an important medium for youth to communicate with like-minded peers who they often never meet offline. At the same time, discussions of deliberate self-harm on the internet have emerged as an issue of concern. Nevertheless, there is a lack of research on how adolescent self-harmers experience their engagement with online self-harm discussion groups. This study explored how adolescent self-harmers make sense of self-harm in online discussions. I conducted an inductive thematic analysis of posts written by adolescent self-harmers in five online self-harm discussion groups. A semantic approach to thematic analysis revealed thirteen key themes that were grouped into three superordinate thematic categories. The first of these categories consists of themes centred around conceptualisations of self-harm. This category includes the themes of how self-harm is conceptualised in the analysed discussions, DSH as a negative addiction, self-harming adolescents‟ complex relationship with their scars, and social affiliation in the context of adolescent self-harming. The second thematic category encompasses themes regarding issues contributing to DSH for adolescent posters. This category includes DSH as a coping strategy, people offline being positioned as unhelpful, keeping DSH secret offline, a negative self-image, comorbidity with other psychological issues, social isolation/loneliness, and school-related issues. The third thematic category consists of themes focused around care and support, including both care and support online and the importance of getting help with DSH offline. Overall, from the results of this study it appears that online self-harm discussion groups have a largely positive influence, with discussions largely revolving around adolescents and older posters who used to self-harm trying to help one another with overcoming their addition to self-harming.