Findings reveal that individuals with lifetime-NSSI exhibit higher levels of alexithymia, favor expressive suppression as maladaptive emotion regulation strategy, and exhibit greater difficulty in adaptive cognitive reappraisal compared to those without NSSI. These findings underscore the importance to address emotion regulation and alexithymia in NSSI interventions. This is the first study to report a link between alexithymia and the endorsement of specific (intrapersonal-positive) NSSI functions.