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Background: The current systematic review and meta-analysis aims to synthesize findings from Italian studies that have investigated emotional and behavioural problems in clinical and at-risk samples of adolescents, as assessed by the Achenbach System of Empirically Based Assessment (ASEBA) instruments, including Child Behaviour Checklist (CBCL), the self-report Youth Self Report (YSR) and the teacher-report Teacher Report Form (TRF). It also investigates possible effects of gender, age, and time of assessment (pre-post COVID-19 pandemic), and their link with other psychological factors. Methods: The latest PRISMA guidelines were followed, and this study was registered in PROSPERO (CRD42022299999). Scopus, EBSCO, PubMed, Web of Sciences, and ProQuest databases were used considering the time frame from January 2001 to November 2021. Two blinded investigators remove duplicates and double screened 7103 records. They selected and extract information from 40 eligible studies, which were also evaluated through the Newcastle-Ottawa Scale. Results: Overall, emotional-behavioural problems were mainly investigated through the CBCL 6-18 both in clinical samples (N = 2244), mostly composed of adolescents with a diagnosis of eating disorders and externalized disorders, and at-risk samples (N = 868), mostly of adolescents with a medical condition. As expected, adolescents from clinical samples had higher scores on the ASEBA scales than their peers belonging to the at-risk samples. No effect related to gender, time of assessment and study quality on emotional behavioural problems emerged. However, a significant effect of age was found in clinical samples, specifically a decrease in externalizing symptoms with the increase of age. Lastly, emotional-behavioural problems were mainly investigated in association with emotional regulation difficulties both in clinical and at-risk samples. Conclusions: For the first time, meta-analytic data on rates of emotional-behavioral problems in Italian clinical and at-risk adolescents are provided. Implications include the need of more data, especially with the TRF and from Centre e Southern Italy, to solve doubts emerged about the absence of moderators. The authors discuss limitations related to the heterogeneity of the studies, suggesting future research directions. [ABSTRACT FROM AUTHOR]