Chest pain is highly prevalent in adolescence, represents a considerable burden for health services, and rarely associated with cardiac disease. Since psychosocial factors are related to chest pain there is a need for exploring the accompanying family functioning and mental health problems in adolescents with non-cardiac chest pain. Here, we assessed these determinants in 68 adolescents with non-cardiac chest pain and 68 age and-sex matched control participants using the 4-item Patient Health Questionnaire-4 for a brief screening for anxiety and depression and the Family APGAR Scale to assess the perception of family functioning. Adolescents with non-cardiac chest pain reported more depression, anxiety and experienced impaired family functioning (p=0.003, p<0.001, p<0.001). The results indicated that non-cardiac chest pain is a warning sign of an underlying mental health problem with accompanying family issues and it deserves further psychosocial investigation including anxiety, depression, and impaired satisfaction of the adolescents’ family’s responsiveness.