The critical changes in physical appearance during adolescence can considerably influence the self-appraisal of body image. The purpose of this study is to analyze body self-image gender differences in Mediterranean adolescents, and his relationships to the anthropometric characteristics of this population in different phases of the adolescence. Participants were 809 Mediterranean teenagers (396 females) aged 11 to 17. A relative low prevalence of dissatisfaction with body image was observed among healthy urban Mediterranean adolescents (boys 17.3%; girls 22.7%). Girls showed statistically significantly higher mean BSQ scores than boys (M = 61.7, SD = 26.6 versus M = 56.3, SD = 27.1; p < 0.001). Girls in the late adolescence were more often classified as being dissatisfied (31%) in comparison to those in the early adolescent group (19.1%; p < 0.05). There was a good correlation of BSQ scores with all the anthropometric variables in males but not in females.