Background: Adolescence is a developmental stage with dramatic changes in bio-psycho-social functioning, which may play a role in adolescent psychopathology and social adjustment. In addition to the gender and age effects, pubertal development has been suggested to be an important confounding factor in many positive results regarding adolescent psychopathologies. This paper reviews the literatures regarding the association between pubertal development and psychopathology, substance use, suicidality, and sleep-wake patterns at adolescence. Methods: We searched PubMed, MEDLINE and PsycInfo for relevant studies published in the English and Chinese languages between January 1, 1997 and October, 2007, and included 60 studies in this review. Results: Most samples were restricted to Caucasian populations. Modest to strong evidence has been found to support the association of advanced pubertal stage and/or early pubertal timing with an increased risk of depression, substance use, self-harm, disordered eating, and earlier sexual behaviors in both adolescent boys and girls, and psychosocial functioning anxiety conduct problems conduct problems in adolescent girls. Results regarding the role of pubertal development on adolescent sleep-wake pattern and sleep phase delay are controversial. Conclusion: Western studies suggest that advanced pubertal stage and early pubertal timing are associated with a wide range of adolescent psychopathology and risk behaviors. Whether the same finding could be applied to the Taiwanese adolescent population requires further study to examine.