Purpose: The purpose of this paper is to identify and describe adolescents' health-related behaviours from a socio-ecological perspective. Socio-ecological factors have been widely shown to be related to health behaviours (smoking, alcohol consumption, physical activity and diet) in adolescence and to affect health. The review integrates evidence with socio-ecological factors (social relationships, family, peers, schooling and environment). Design/methodology/approach: The data were collected from electronic databases and by manual search consisting of articles (n = 90) published during 2002-2014. The selected articles were analysed using inductive content analysis and narrative synthesis. Findings: The findings suggest that there was a complex set of relations connected to adolescent health behaviours, also encompassing socio-ecological factors. The authors tentatively conclude that socio-ecological circumstances influence adolescents' health-related behaviour, but that this review does not provide the full picture. There seemed to be certain key factors with a relation to behavioural outcomes that might increase health inequality among adolescents. Practical implications: School health education is an important pathway for interventions to reduce unhealthy behaviours among adolescents including those related to socio-ecological factors. Originality/value: Some socio-ecological factors were strongly related to health behaviours in adolescence, which may indicate an important pathway to current and future health. This paper may help schoolteachers, nurses and other school staff to understand the relationships between socio-ecological factors and health-related behaviours, which may be useful in developing health education to reduce health disparities during adolescence.