Vitamin mineral supplement (VMS) consumption is prevalent among the population, particularly adolescents. However, literature about the factors associated with the reasons for consuming VMS has not been investigated in Malaysia, indeed adolescents’ nutrition is important as they experience body change during this period. Thus, this cross-sectional, national health study aims to determine the association between nutritional status, dietary practice and reasons for VMS consumption among secondary schools in Malaysia. A total of 40,087 adolescents aged 10-18 completed the questionnaire. Among them, only 22.6% (9,077) of them from secondary school consumed VMS and were included in this study. Gender, height-for-age, strata, ethnicity, hunger experience, eating out and breakfast intake frequency were associated with the reasons for VMS intake. After the adjustment, stunted adolescents were more likely to consume VMS due to the doctor’s prescription (RRR:1.51, 95% CI: 1.11-2.10). Adolescents who sometimes experienced hunger were more probable to consume VMS due to doctor’s instruction, self-awareness and friends’ influence as compared to other unspecified reasons (RRR: 1.41, 95% CI: 1.08-1.85; RRR 1.38, 95% CI: 1.07-1.77; RRR: 1.98, 95% CI: 1.27-3.08, respectively). No association was found between dietary behaviour and the reason for the VMS intake. For meal pattern, adolescents who skipped breakfast were less likely to consume VMS due to doctor’s instruction, parents’ advices and self-awareness (RRR: 0.53, 95% CI: 0.39-0.72; RRR: 0.50, 95% CI: 0.38-0.66; RRR: 0.59, 95% CI: 0.45-0.78, respectively). This study suggested that further studies were needed to investigate the role of VMS use in relation to nutrient adequacy, overconsumption and health.