Introduction: Weight and shape dissatisfaction is an important determinant of adolescent mental health and has been increasingly linked to psychological stress. There is a paucity of research examining this relationship among adolescents in Sri Lanka. Objectives: This study was conducted to assess weight and shape dissatisfaction and itsassociation with perceived stress level of the adolescent schoolchildren in Galle district, Sri Lanka. Methods: A school based, cross-sectional study was conducted among 876 adolescent schoolchildren aged 16-19 years in Galle district selected using cluster sampling technique. Weight and shape dissatisfaction was assessed using validated, Sinhala version of Eating Disorders Examination Questionnaire 6.0. Perceived stress level was assessed using validated, Sinhala version of Perceived Stress Scale. Data were analyzed using Statistical Package of Social Sciences software, version 30 using descriptive statistics and Chi square test. Results: Mean age (SD) of the adolescents was 16.27 (0.58) years. Weight dissatisfaction was reported among 28.7% of the adolescents while 27 .8% reported shape dissatisfaction. Among them, 19.2% had moderate to marked weight dissatisfaction and 18.6% had moderate to marked shape dissatisfaction. Low perceived stress was reported among 14.6% while 80% had moderate stress and 5.4% had high perceived stress. Both weight and shape dissatisfaction was significantly associated with high stress among adolescents (p