INTRODUCTION:Although multi-site pain is common in adolescents, pain conditions are frequently diagnosed and treated in isolation. Little is known about whether there are specific sites in which pain commonly co-occurs. This study examines the patterns of pain in adolescents, and whether these are associated with sports participation, health-related quality of life (HRQoL), and sex. METHODS:In previously collected cohort data ('Adolescent Pain in Aalborg-2011'), adolescents (aged 12-19) completed an online questionnaire, including demographic data, current pain sites, sports participation and HRQoL (assessed by Euro-QoL 5D-3L). Latent class analysis was used to classify spatial pain patterns, based on the pain sites. The analysis included 2953 adolescents. RESULTS:Four classes were identified as follows: (1) little or no pain (63% of adolescents), (2) majority lower extremity pain (10%), (3) multi-site bodily pain (22%) and (4) head and stomach pain (3%). The lower extremity multi-site pain group reported highest weekly sports participation (p < 0.001; mean: 2.9 days/week; 95% CI 2.7 to 3.2), while the multi-site bodily pain and the multi-site head and stomach pain groups had lowest EQ-5D scores (p < 0.001). Males were more likely to belong to the little or no pain class, whereas females were more likely to belong to the multi-site bodily pain class. CONCLUSIONS:Latent class analysis identified distinct classes of pain patterns in adolescents, characterized by sex, differences in HRQoL and sports participation. The class with multi-site bodily pain and reduced quality of life was the largest among adolescents reporting pain, and future research on treatment strategies should consider targeting this group.