Background: Adolescent males are more likely to sustain intentional and unintentional injuries, be involved in a physical confrontation, and be successful in suicide attempts. Body image dissatisfaction (BID) has been linked as a possible contributing factor to these negative health behaviors and risks; however, research is limited with males. The interaction of intrapersonal, interpersonal, and social variables in a holistic model has yet to be explored for males. Variables precipitating adolescent males to develop an unhealthy body image and act on negative health behaviors, such as body image drug use, were the impetus for this study. Methods: A randomized cross-sectional sample of 330 adolescent males answered questions concerning body image using the Adolescent Body Image Satisfaction Scale (ABISS). Pearson product moment correlations and stepwise regression analyses identified the strongest predictive variables of BID. Results: The strongest contributing variables accounting for 56.7% of model variance were desire for the body of another person (r = 0.571, p less than 0.001), teasing (r = 0.490, p less than 0.001), satisfaction with their body when they were younger (r = 0.450, p less than 0.001), and difficulty coping with criticism (r = 0.443, p less than 0.001). No statistically significant differences were found for racial/ethnic background (p less than 0.822, "n.s."). Conclusions: Educators and school districts should consider the confluence of psychosocial variables affecting body image and adolescent male health risk behaviors based on a statistically sound predictive model as provided by the ABISS. Targeted programming to enhance body image and address teasing/bullying behaviors is strongly recommended. (Contains 5 tables.)