Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, disorganization, and/or hyperactivity/impulsivity. Aims and Objectives: To study the prevalence of ADHD in adolescents referred for behavioral problems to rural tertiary health care center, to identify the gender difference andco-morbid factors associated with ADHD. Materials and Methods: Present study was a hospital based cross sectional study done at rural tertiary health care centre in central India. Multi Health Systems (MHS) CONNERS-3 questionnaire was used for assessment. Adolescent boys/girls referred by school or brought by their parents for behavioral problems at Child Guidance Clinic, Department of Pediatrics, were included in the study. Results: Amongst 148 study subjects, 21 subjects (14.18%) were diagnosed with ADHD, 73 (49.32%) were diagnosed with inattention, 58 (39.18%) with impulsivity/hyperactivity, 112 (75.67%) with learning problems, 62 (41.89%) with aggression, and 103 (69.58%) with family relation problems. There was statistically significant gender difference in the prevalence of ADHD, with male preponderant; male: female ratio was 3.2:1. Conclusion: The present study revealed that prevalence of ADHD is high amongst adolescents in rural health care setting. It is needed to formulate policies in rural India for effective combating ADHD at early age.