Introduction: Adolescence represents a key period of intense development and transformation for young individuals. During this time, students go through numerous physical, emotional, and academic changes that can have a profound impact on their mental health and well-being. School performance, participation in extracurricular activities, body weight, and mental health are often considered key aspects of the adolescent experience. Understanding their interrelationships and influence on the emotional well-being of adolescents is becoming increasingly important in the context of comprehensive care for their development. Objective: to examine the relationship between school success, sports extracurricular activities, body mass index centile and mental health among eighth-grade elementary school students. Methods: 210 students of the eighth grade of elementary schools in Rijeka participated in the research. Emotional distress was measured with the YP emotional distress questionnaire. Results: The total score on the emotional disturbance scale was relatively low, with an average value of 8.13 (5.39). Girls scored statistically significantly higher on the scale of emotional distress than boys. Students who have a lower level of emotional distress achieve higher school success and participate in extracurricular activities. Students who have a higher body mass index score higher on the emotional distress scale. Female gender and lower school performance are statistically significant predictors of a higher level of emotional distress among 8th grade students, while attendance at extracurricular activities is at the limit of statistical significance, while body mass index did not prove to be a statistically significant factor in explaining the variance of emotional distress. Conclusion: In the sensitive period of adolescence, it is important to provide support and understanding. This may include collaboration with families, school counselors or mental health professionals to provide appropriate support and intervention when necessary. It is also important to work on promoting positive interpersonal relationships and creating a safe environment at school to reduce emotional distress in students.