Purpose: The purpose of this study was to describe high-risk health behaviors in middle school adolescents and to identify factors related to this behavior. Method: This survey study employed a self administered questionnaire given to 621 students enrolled in one middle school located in Gyeonggi province. Using the cluster sampling method, 4 classes from the 7th, 8th, and 9th grades were selected. The survey was done between April 20 and May 19, 2004. Data were analyzed using SAS. Result: The results showed that 19.1% of adolescents smoked cigarettes and 8.4 % drank regularly. The mean score for resilience was 6.92 (range:0-10) and for depression, 23.62 (range:0-50). The adolescents in higher grades reported significantly more experience with pornography. Also, adolescents who reported have fewer conversations with their parents had significantly more experience with pornography. Depression was significantly higher for those students who had better academic skills and higher family income. Resilience level was significantly higher for the students who reported better schools records and higher family income. The most important factor related to the high risk behaviors, depression, and resilience was conversations with parents. Conclusion: This study suggests that to develop an effective high-risk health behavior prevention program for adolescents, it is necessary to include communication skills with the parents.