The purpose of the study was to examine fruit and vegetable intake patterns among American Indian and Alaska Native adolescents and to assess psychosocial factors and health behaviors related to inadequate consumption. The study was conducted in nonurban schools from eight Indian Health Service Areas in the U.S.A total sample of 13,454 7th- through 12th-grade American-Indian and Alaska-Native youths living on or near reservations were given, in classroom settings, a revised version of the Minnesota Adolescent Health Survey. The health questionnaire assessed fruit and vegetable consumption patterns and psychosocial variables and health-related behaviors. The results indicated that fruit and vegetable consumption was below the recommended amounts. Less than daily consumption of vegetables was reported by 30% of adolescents and less than daily consumption of fruits was reported by 20% of youths. Psychosocial and health behavior risk associated with inadequate intake included being overweight, low family connectedness, poor school achievement, poor perceived health status, and tobacco use. Our study shows that fruit and vegetable consumption is low among American-Indian and Alaska-Native youths. More attention needs to be placed on developing culturally appropriate interventions to promote healthy eating patterns and addressing factors related to inadequate intake.