This study examines the impact of regional conditions on adolescents’ emotional development by analyzing differences in the trajectories of social withdrawal and depression between urban and rural areas and identifying regional factors that influence emotional changes. To achieve this, data from the Korean Children and Youth Panel Survey 2018 (KCYPS 2018), specifically from the 1st to 6th wave of the 1st-year middle school cohort, were utilized, and a multi-group piecewise latent growth model was applied. The main findings are as follows. First, adolescents in urban areas exhibited lower initial levels of social withdrawal and depression compared to those in rural areas, highlighting regional disparities. However, the gap in depression levels narrowed over time as urban adolescents experienced an increase in depression during high school. Second, the initial levels and changes in adolescents’ social withdrawal were significantly influenced by geographical characteristics (e.g., whether the area is part of the Seoul metropolitan area), educational conditions (e.g., the number of private academies), and social safety (e.g., the inverse of the number of reported crimes) in both urban and rural areas. These factors exhibited similar effects across both types of regions. Third, the factors affecting the initial levels and changes in adolescent depression varied between urban and rural areas. Notably, in urban settings, a highly competitive educational environment had a significant impact on adolescent depression. These findings suggest that regional characteristics, in addition to individual and school-related factors, play a significant role in adolescents’ emotional development. This indicate that educational disparities between urban and rural areas may manifest not only in cognitive domains but also in emotional domains, highlighting the need for differentiated policy support that takes regional contexts into account.