Objectives/Hypothesis To evaluate the prevalence, characteristics, and associated risk factors of tinnitus in U.S. adolescents. Study Design Cross-sectional analyses of U.S. representative demographic and audiometric data, the National Health and Nutrition Examination Survey (NHANES) 2005 to 2008. Methods The study population consisted of 3,520 individuals aged 12 to 19 years with complete tinnitus-related data. Tinnitus was defined as the presence of ringing or buzzing in the ears lasting for at least 5 minutes during the preceding 12 months. In addition, we defined a chronic tinnitus subgroup as being bothered by tinnitus for more than 3 months. Demographic and other data regarding tinnitus, smoking, body mass index (BMI), anemia, hypertension, history of ear infections, tympanostomy tube placement, otoscopy, tympanometry and hearing thresholds, history of firearm use, and recreational and occupational exposure to noise were extracted and analyzed. Results Overall, tinnitus lasting 5 minutes or more in the preceding 12 months was reported by 7.5% of the 12- to 19-year-old population. This represents about 2.5 million adolescents in the United States. The prevalence of chronic tinnitus was 4.7%, corresponding to about 1.6 million adolescents in the United States. Multivariable-adjusted analysis revealed that both overall and chronic tinnitus were associated with female gender, low income, exposure to passive smoking, type A tympanogram, and occupational and recreational noise exposure. History of ≥3 ear infections and history of tympanostomy tube placement were associated only with overall tinnitus. Conclusions Tinnitus afflicts a substantial portion of the youth population. Further investigation of the association between tinnitus and the identified risk factors is warranted. Level of Evidence N/A. Laryngoscope, 123:2001-2008, 2013 © 2013 The American Laryngological, Rhinological and Otological Society, Inc.