Emerging research suggests that adolescents at high-achieving schools (HAS) in Western societies are at elevated risk for problem behaviours. This cross-sectional study explored whether adolescents attending HAS in a non-Western setting show similar risk patterns and if contextual (school-, family-, and peer-based) factors typically associated with the excessive pressures to achieve predict these problems. Participants were 237 adolescents (14-18 years old), and one of their parents, who were recruited from high-achieving private schools in Hong Kong. The parent-child dyads completed questionnaires on youth internalizing and externalizing problems and perceived stressors. Multiple linear regressions were conducted to test whether academic demands, parent-related stressors, and social status among peers were associated with youth problem behaviours, after controlling for age and gender. The study found that nearly half of the female adolescents and over a third of the males met borderline-clinical levels ([greater than or equal to] 86%ile) of internalizing problems; moreover, more females than males met clinical criteria ([greater than or equal to] 98%ile) for self-reported externalizing problems and parent-reported internalizing problems. Academic demands, parent-related stressors, and social status among peers predicted youth-reported internalizing problems; and the latter two factors contributed parent-reported internalizing problems. However, only parent-related stressors significantly predicted youth- and parent-reported externalizing problems. The findings provide preliminary indication that HAS adolescents from Hong Kong may be an "at risk" group, highlighting the need for increased awareness and targeted interventions.