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Purpose: The purpose of the study was to investigate health behavior changes in Korean adolescents before and during the COVID-19 pandemic. Methods: A descriptive cross-sectional design was employed. Data were obtained from the 15~16th (2019~2020) Korea Youth Risk Behavior Web-based Survey. Overall, the data of 112,251 students, 57,303 before the COVID pandemic and 54,948 during the pandemic, were included. The data were analyzed using rao-scott x2-test, t-test, ANCOVA and logistic regression analysis. Results: While sitting time for study decreased, sitting time for leisure increased in the 2020 group compared to the 2019 group. The 2020 group was more likely to skip breakfast and have a higher BMI than the 2019 group. The 2020 group was less likely to consume fruit and engage in moderate and vigorous physical activities than the 2019 group. The 2020 group was less likely to engage in CC, EC, and HTP current smoking and be exposed to secondhand smoke at home, school, and public places than the 2019 group. The 2020 group was more likely to be satisfied with sleep, but less likely to experience stress, depression, suicidal ideation, suicidal plans, and suicidal attempts than the 2019 group. Conclusion: It is necessary to reduce sedentary time, encourage physical activities, manage smoking and drinking rates continuously, and establish a network system to prevent psychological loneliness and isolation for adolescents, which requires participation of experts from the community as a whole.