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Background: Thoracic spine pain (TSP) is relatively common in children and adolescents., Aims: To determine the prevalence of TSP in adolescents and analyze its association with sociodemographic characteristics, use of electronic devices, physical activity, and mental health., Design: Cross-sectional epidemiological study., Setting: A high school in Bauru City, São Paulo, Brazil., Participants/subjects: In total, 1,628 students aged 14-18 years., Methods: Participants were selected by cluster sampling in two stages, and data were collected via face-to-face interviews. Data regarding the following were collected: (1) sociodemographic aspects; (2) use of electronic devices; (3) regular physical activity level; (4) mental health; and (5) TSP., Results: The prevalence of TSP was 51.5% (95% confidence interval, 49.1-53.9) and the variables associated with TSP were female participant sex (prevalence ratio [PR] = 1.96; 1.61-2.38), use of computers for >3 hours per day (PR = 1.29; 1.01-1.66), use of computers >3 times per week (PR = 1.35; 1.03-1.75), use of cell phones in a semi-lying position (PR = 1.37; 1.11-1.69), use of cell phones for >3 hours per day (PR = 1.44; 1.12-1.85), use of tablets in the sitting position (PR = 1.47; 1.07-2.01), and presence of mental health problems (PR = 2.10; 1.63-2.70). Physical activity was a protective factor (PR = 0.84; 0.73-0.96)., Conclusions: There is a high prevalence of TSP in adolescents, with a marked association with female participant sex, use of electronic devices, and presence of mental health problems Physical activity is a protective factor. Understanding the relationship between risk factors and adolescent spinal pain may be important in both the prevention and treatment of spinal pain in this age group., Competing Interests: Declarations of Competing Interest None., (Copyright © 2021 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)