Background: Substance use among adolescents is a complex and multidimensional problem. Parental substance use, family conflict, poor family management practices and affiliation with peers using illicit drugs are important risk factors for addiction. Aim of Study: The aim of this study is to assess impulsivity, peer relationships and parent relationship among adolescents with substance use disorders. Subjects and Methods: Eighty adolescents were included in this study, 40 patients with substance use disorder and 40 healthy adolescents as a control group. All subjects of the study were subjected to: Drug abuse history, Arabic Version of (MINI-KID), IQ assessment, Substance Use Risk Profile Scale (SURPS), Socioeconomic Status Scale for Health Research in Egypt, questionnaire of parental attitudes as realized by adolescents and Inventory of Parents and Peer Attachment. Results: There was no statistically significant difference between both groups as regards age, sex and residency. Fortyfive percent of adolescents with substance abuse came from single parent families. The patients had significantly more positive family history of substance use disorders (p=0.012) and more family history (p=0.013) of psychiatric disorders. Tramadol is the most common abused substance 37.5%. The most common psychiatric co-morbidities in patients group were conduct disorder (22.5%) and major depressive disorder (15%). Impulsivity, anxiety sensitivity and hopelessness were significantly increased among patients group than control group (p=0.001), (p=0.006) & (p=0.001) respectively. Fathers of patients showed significantly higher consistency with their sons (p=0.021) as well as higher rejection (p=0.002), while the mothers of patients showed significantly higher independency (p=0.005) than control group. Adolescent with substance use disorders had significant less trust and communication with their friends (p=0.009), (p=0.001). Patients has significantly more friend with history of substance use disorders (p=0.011). Conclusions: Poor family management practices and relationships to peers using illicit drugs are important risk factors for addiction. There are certain psychiatric disorders associated with substance use such as conduct disorder and