Purpose : Health Risk behaviors are a leading cause of preventable morbidity and mortality. Adolescents is a critical transitional period for establishing health behavior for healthy life. The purpose of this study was to describe the types and frequency of the health risk behaviors being performed by middle school students, examine the gender and grade differences of health risk behaviors, and identify the relationship among health risk behaviors. Methods : A total of 1952 early adolescents recruited from 7 middle schools in a district of urban setting completed questionnaires. Youth Risk Behavior Survey-Middle school questionnaires was used to identify the types of health risk behaviors among early adolescents. Data were analyzed by descriptive statistics and Chi-Square test using SAS program . Results : The results showed the frequency for most health risk behaviors and increased with advancing grade level. Males were more likely than females to behaviors related to smoking and violence, whereas females were more likely than males to have suicidal thoughts, be physical inactive and attempt to lose weight. Among health risk behaviors, the relationship of alcohol experience, smoking, and suicide was high. Conclusion : The findings identify a high risk target group among middle school adolescents and suggest that preventive intervention strategies should take into consideration the types with gender and grade, and provided the evidence that one of health risk behaviors may induce the other health risk behaviors.