Purpose: The principal objective of this study was to assess the relationships of depression, fatigue, BMI, and health locus of control between urban and rural female middle school students. Methods: The study subjects included 377 girls in randomly-sampled middle schools in urban and rural provinces. The data were collected via self-recorded questionnaires from April 21.- to May 2. 2008, and analyzed using the SPSS Win 12.0 program. Results; 1) The mean score of depression was $10.22{pm}5.72$ (urban), $10.81{pm}4.92$ (rural). 2) The mean fatigue score was $50.43{pm}1.57$ (urban), $51.90{pm}9.70$ (rural). 3) BMI was classified into 3 groups: leptosomic, normal weight, and obesity groups. The mean BMI score was $18.73{pm}2.05$ (Seoul), and $20.31{pm}3.26$ (provincial). 4) The internal locus of control was higher than the external locus of control (urban). 5) Fatigue was correlated with depression (r=.512, p=.000) in both areas. The health locus of control was correlated with Fatigue (r=.153, p=.042) in province. Conclusion: An effective program to reduce the levels of fatigue and depression for middle school girls and to maintain normal weight is required. In particular, the high-risk depression group can be managed through community mental health care center deep interviews, and close observation.