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Nutrition during adolescence influences long-term health outcomes. Consumption of fish has many health benefits, yet few studies have investigated associations between fish intake and nutrient intake and lifestyle factors in adolescents. A cross-sectional study utilizing 24-hour dietary recalls obtained by in-person interviews investigated relationships between fish intake and demographic characteristics, nutrient intake, and lifestyle factors among adolescents (mean age = 15.5 years). Height, weight, and self-administered survey data were collected from 839 high school students who took part in the 2000-2004 Hawaii Nutrition Education Needs Assessment survey. About 8.5% of the students consumed fish, based on estimated EPA (eicosapentaenoic acid) + DHA (docosahexaenoic acid) intakes. Adolescents who consumed fish had higher intake of protein, water, B vitamins, magnesium, selenium, and zinc but consumed more calories, fat, saturated fat, and sodium. Considering the school health program's potential to reach adolescents, more intensive school-based interventions can be directed to promote safe fish consumption and to encourage other positive lifestyle behaviors., (© 2013 APJPH.)