Objectives: The study aimed to investigate the determinants of problematic social media use (PSMU) among Polish adolescents by accounting for time spent on social media, sociodemographic characteristics, individual resources, social environment, and health factors, and to compare the findings with previous research. Material and Methods: A cross-sectional, anonymous, online survey was conducted in 2024. The study was performed among adolescents in the Lubuskie Voivodeship, Poland and included 9073 students aged 12–19 years (mean [M] ± standard deviation [SD] 15.16±1.56 years). Problematic social media use was assessed using the 9-item Social Media Disorder Scale (SMDS). Independent variables included sociodemographic characteristics, time spent on social media, health literacy, future orientation, school achievements, subjective health complaints, well-being, school stress, parent and peer relations, and school climate, measured with validated instruments derived mainly from the Health Behaviour in School-aged Children (HBSC) survey protocol and the KIDSCREEN-27 questionnaire. Results: Problematic social media use was identified in 12.7% of participants. Higher PSMU was observed among younger adolescents. The strongest predictor was the time spent on social media >5 h/day. Poorer health and well-being – including multiple psychosomatic complaints, lower well-being, and higher school stress – were strongly associated with PSMU. Lower future orientation, low health literacy, and poorer relationships with parents increased the likelihood of PSMU, whereas older age, higher future orientation, and supportive parent relationships decreased. Conclusions: Multiple factors influenced PSMU among adolescents, although the overall model fit remained modest. Boys were more likely to experience PSMU, representing a novel observation. Higher future orientation, supportive relationships with parents, and older age were key protective factors. A non-linear relationship was found between PSMU and peer support as well as school climate. Int J Occup Med Environ Health. 2026;39(3)