Objective: To evaluate the relationships between alexithymic personality traits and meta-cognitive problems, and psychological and behavioral problems associated with alexithymia in adolescents. Methods: This cross-sectional study was conducted on 570 high school students (58% female, n=331; 42% male, n=239) in five high schools in Istanbul. Toronto Alexithymia Scale (TAS-20), Meta-Cognition Questionnaire for Children and Adolescent (MCQ-C) and Strength and Difficulties Questionnaire (SDQ) were used. The parents were asked to complete Sociodemographic Questionnaire. Statistical analysis was performed with SPSS 24 program and statistical significance level was set at p<0.05 and p<0.001. Results: There was no significant difference in terms of age between the alexithymia group (58% female, n=63; 42% male, n=46) and the comparison group (58% female, n=268; 42% male, n=193). Also, there was no significant relationship between gender and alexithymia. Negative meta-worry, superstition beliefs, punishment and responsibility beliefs and total meta-cognitive problem scores of the alexithymia group were significantly higher than comparison group. SDQ total problem scores, attention deficit and hyperactivity scores, peer problems, conduct and emotional problem scores were significantly higher; pro-social behavior scores were significantly lower in the alexithymia group compared to the comparison group. Total TAS-20 scores were positively correlated with total MCQ-C scores and total SDQ scores, significantly. Additionally, total scores of the MCQ-C and SDQ significantly predict the alexithymia. Conclusion: Meta-cognition abilities have functions in checking and regulating the emotions as well as regulating the cognitive processes. It should be kept in mind that the core feature of the individuals with alexithymia is the lack of identifying and expressing emotions, therefore it may be suggested that meta-cognitive problems increase the risk of alexithymia. In addition, the results indicated that alexithymia is frequently associated with attention deficit and hyperactivity, emotional and behavioral problems in adolescents. These results indicate that focusing on meta-cognitive errors may increase the effectiveness of treatment of the adolescents with alexithymia. Additionally, mental and behavioral problems accompanying the alexithymia should not be overlooked.