A cross-sectional descriptive survey to assess adolescents health related problemsrnand service utilization pattern and preferences was conducted from January tornDecember 2000 in randomly selected school adolescents in Addis Ababa. Data wererncollected using an anonymous self-administered questionnaire.rnA total of 2647 high school students from 13 schools participated in the study. Ofrntheses 1177(44.5%) were males and 1470(55.5%) were females. Five hundred fiftyrneight (21.9%) adolescent reported to be sexually active. Condom use during the lastrnintercourse among the sexually active was 72.9%. Forty-four (7.9%) of the sexuallyrnactive adolescents claimed to have had symptoms of STD in the past three months.rnAmong the sexually active female, 32 (5 .7%) claimed to have been pregnant out ofrnwhich 22 (68.8%) ended up in abortion. Overall 1045 (39.5%) of the students reportedrnthe use of at least one of the substa nces (alcohol, cigarette, kaht or cannabis);rn1229(51.6%) had mental distress, and 284(10.9%) had attempted suicide in the past.rnSeven hundred eighty three (32. 3%),523(24.5%) and 610(25.9%) of the adolescentsrnclaimed that the existing reproductive health services are inaccessible, unaffordablernor unacceptable respectively for adolescents. For 1852(72.0%) of the adolescentsrnfeeling of embarrassment at seeking reproductive health service was the reason forrnnot utilizing existing service while 1738 (67.8%) claimed it was for fear of being seenrnby parents or others. The majority 1402 (57.0%) claimed that service fees arernunaffordable for adolescents. Five hundred fifty two (21.6%) preferred to have ARHSrnwith in the existing system but with special approch to adolescents by servicernproviders, while 1070(41 .9%) in separate setting outside of the existing servicernincluding youth centers.rnIt was concluded that adolescents have specific health problems, risk taking and carernseeking behavior that have not been well addressed by the existing health services.rnHence recommended that organizing youth friendly RHS be given an urgent attentionrnby decision makers, public health planners and health care providers at all levels.rnVI I