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Objective: School absenteeism and grade retention are associated with various life-course problems. In this study, we examined school absenteeism and grade retention in Ethiopian adolescents, as well as factors associated with them. Methods: We analyzed data from 1200 adolescents (aged 10-14 years) from 20 public primary schools in Addis Ababa, Ethiopia. We carried out multivariate logistic regression analyses, adjusting for school-level clustering, to determine the factors associated with school absenteeism and grade retention. Results: Grade retention, father's lower education, parental occupation other than a government job, household food insecurity, being in large schools, and not having toilets in the school were associated with higher absenteeism rates, while involvement in paid work was associated with lower absenteeism rates. Having educational resources at home was associated with lower odds of retaining a grade but having mental health problems and a father's occupation other than a government job were associated with higher odds of grade retention. Conclusions: Interventions aiming to increase school presence and performance among urban Ethiopian adolescents may require a multi-level approach addressing food insecurity, psychosocial problems, and provision of sanitation facilities at schools. [ABSTRACT FROM AUTHOR]