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Objective: Body image dissatisfaction is a prevalent concern among adolescents, with potential implications for mental and physical health. Understanding its correlates in diverse cultural contexts, such as Iran, is crucial for developing targeted interventions. This study aimed to investigate the demographic {Body Max Index (BMI), gender, etc.} socioeconomic status and family structure associated with body image dissatisfaction in a sample of adolescent students in Tehran, Iran. Method: This cross-sectional study included 1,430 students (grades 7, 8 and 9) from randomly selected schools in Tehran. Body image dissatisfaction was assessed using a validated international questionnaire measuring demographics, body perceptions, eating patterns, and family structures. Self-reported weight height values were used to calculate BMI. Misperceived body status was defined as discordance between self-perceived image and actual BMI category. Statistical analyses included chi-square tests, t-tests, and multivariate regression (SPSS v26). Results: A total of 1, 430 participants completed the questionnaires and the mean age of participants was (14.13 ± 1.2), and 54.8% were females and 785 males (54.9%). The findings revealed that 59.1% of adolescents misperceived their body status. Female gender (OR = 1.5, 95% CI: 1.18–1.90, P = 0.001), lower family SES (socioeconomic status) (OR = 4.27, 95% CI: 1.87–9.74, P < 0.001), higher BMI (OR = 1.09, 95% CI: 1.06–1.12, P < 0.001), and non-biological family structures (OR = 0.79, 95% CI: 0.26–2.3, P = 0.05) were significantly associated with body dissatisfaction. Students living with stepparents or relatives reported lower body satisfaction compared to those living with biological parents. These findings underscore the importance of gender, socioeconomic status, family structure, and BMI as key factors influencing body image dissatisfaction among adolescents. Conclusion: These findings highlight the importance of gender, socioeconomic status and family structure in body dissatisfaction among adolescents. Importantly, these findings reflect the heightened challenges facing youth in the post-COVID-19 era, during which lifestyle changes, increased social media exposure, and altered social interactions have intensified body image concerns. Further research is needed to explore this correlation in more detail and to develop culturally appropriate interventions to promote positive body image.