INTRODUCTIONApproximately one-fifth of the world's populations are adolescents (10-19 years) with more than 80% living in developing countries. Adolescents represent 22% of the Egyptian population.1 Adolescence period is a critical stage of life marked by physical, psychological and social changes. It is a transitional foundational period of development that is liable to change from a neurobiological, behavioral, and psychosocial perspective.2 Headache refers to a pain in the area of the head as an outcome of an interaction of biological, psychological or social factors. It is one of the most mentioned health complaints in adolescents. Globally, around 60% of children and adolescents are liable to headache and may have attacks of variable frequency. Pre-pubescent boys are more frequently affected than pre-pubescent girls, however, after the onset of puberty, headaches occur more frequently in girls. 4 A systematic review of population-based studies on headaches and migraines in children and adolescents estimated that the prevalence of headaches and migraines ranges between 58.4% and 7.7%; adolescent females ABSTRACT Background: Recurrent headaches might be an indication of an underlying disease. It could interfere with the quality of life, school attendance and performance, and daily activities. This study aims to identify factors associated to headaches among male and female adolescents. Methods: This is a secondary analysis of a sample of 548 adolescents of a data set of 863 adolescent students aged 12 to 18 years assessed through a self-administered health questionnaire. The primary survey design was a multistage stratified random sample from preparatory and secondary schools in Cairo and rural areas in Qaliubia governorate, Egypt. No distinction was made between primary and secondary headache. Around 65% of the primary data base was randomly selected by SPSS. Taking gender into consideration, adolescents suffering from at least one headache a week (342) were compared with those who had no complaints of a headache (206). Results: Headaches were reported among 62.4% of the adolescents studied with a significantly higher number of female than male students reporting headaches; 69.9% versus 55.8%. Adolescent males and females with headaches have significantly more weekly symptoms of any disease than those without (18.7% versus 6.8%). They also suffer significantly more abdominal pain, sleep disturbance, feelings of nervousness or dizziness. Significantly more adolescent females (29.1%) suffer from chronic headaches (4-7 times/week) than their male counterparts (8%). Conclusions: Adolescents who play sports have significantly fewer headaches. The most relevant factors associated with headaches with binary regression were dizziness (OR=2), abdominal pain (OR=1.34), sleep disturbance (OR=1.25), and feeling nervous (OR=1.24).