BACKGROUND: Adolescent emotional responses and behaviors are often passed off as growth pangs and academic stress, thereby missing those that need deeper understanding and mental health interventions. AIM: The aim of the study is to understand mental health status among the school adolescents in Tezpur, Assam. MATERIALS AND METHODS: The present study was a cross sectional study that used convenience sampling in selection of the schools. A total of 10 schools were selected for the purpose of the study. 1403 Adolescents were selected for data analysis. Socio-Demographic Performa and Strengths and Difficulties Questionnaire [SDQ] were administered to the participants. RESULTS: The results indicated that five predictors (gender, education, family type, academic performance, socio economic status in the family) explained 9.79% of the variance (F=5.040, P<0.000) in total difficulty levels: (Academic performance; beta=0.08; t=3.15; P=0.002) and (Socio economic status; beta=0.07, t=3.02, P=0.003). CONCLUSION: In the study less than one tenth of the participants have some mental health issues and this calls for concern. Schools should have standing operation procedures in place to periodically screen adolescents for mental health related issues.