Study objective: To determine the frequency of documented depression screening for adolescents presenting with somatic chief complaints to a pediatric emergency department. Methods: We conducted a retrospective chart review of 408 consecutive patients aged 11 to 17 years who presented to the ED with a chief complaint of chest pain, abdominal pain, headache, weakness/fatigue, dizziness/fainting, or hyperventilation. Results: Documentation of depression screening was noted in 4.2% of cases (17 of 408). For patient charts listing both a somatic chief complaint and a similar nonspecific discharge diagnosis, the documentation rate for depression screening rose to 7.5%. No change in screening documentation was noted for chronically ill patients. We did detect a significant difference in screening frequency between black adolescents and adolescents of all other races (P=.021). Conclusion: Our findings demonstrate an extremely low frequency of documentation of depression screening in adolescents with somatic complaints presenting to the ED. Documentation of screening in black patients was still low but was performed at a significantly higher rate. These results indicate a need for education on the adolescent at risk for depression and suicide in the acute care setting. [Porter SC, Fein JA, Ginsburg KR: Depression screening in adolescents with somatic complaints presenting to the emergency department. Ann Emerg Med January 1997;29:141-145.]