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Purpose: The purpose of this study was to identify the prevalence of counselling need for school life problem in middle school students and to investigate characteristics of their family and school life. Methods: Subjects were 7,136 middle school students in Seoul. Data were from 2010 Student Health Examination in Seoul. Cross-sectional study using secondary data was performed. Descriptive, t-test and multiple logistic regression were conducted. Results: 7.2% among subjects required counselling for their school life problem. By demographics, the odds ratios of counselling need were 2.2 times in female, and 1.59 and 1.41 times in 8th and 9th grade vs 7th grade. By region, those of Dongbukbu (Northeast), Seobu (West), and Jungbu (Central) vs Kangnam (South of River) district were 0.46, 0.25, and 0.57 times. With regard to family and school life characteristics, those of inflicted violence, the bullying, family apprehension, and consideration of away from home were 3.38, 3.75, 2.08, and 2.40 times, while that of students having person to discuss was only 0.62 times. Conclusion: It is necessary to activate the school counselling program, especially enforcing support system, not only to enforce resilience of student, but also to decrease the health problems in family and school life.