Background/aims: This study aims to assess adolescents' level of knowledge and attitudes towards low back pain (LBP) as this is required for effective prevention. As knowledge and attitude can influence occurrence, this study correlates adolescents' level of knowledge and attitude towards LBP with its occurrence in Mangalore, India. Methods: A cross-sectional survey with a self-administered questionnaire was conducted among 605 students from four pre-university colleges to evaluate their knowledge of, attitude to, and the occurrence of LBP. Results: This study revealed a moderate level of knowledge (45.39%) and a good attitude (61.95%) towards LBP. The lifetime prevalence of LBP among adolescents is 30.5%. No correlation was found between knowledge and the occurrence(chi(2)=5.03, P=0.17) but a correlation exists between adolescents' attitudes and the occurrence of LBP (chi(2)=14.64, P=0.002). Conclusion: Even with a moderate knowledge and a good attitude, the number of adolescents with LBP is considerable in this region and, therefore, prevention strategies need to be initiated.