Background: The orphanhood is a widespread phenomenon in both developed and developing countries. Adolescent orphans have a wide range of fundamental problems and unmet needs that affect their health and development. Aim: to identify the needs and problems of adolescent orphans at governmental residential institutions in Alexandria. Setting: The study was carried out in 22 governmental residential institutions, in Alexandria, Egypt. Subjects: 250 resident adolescent orphans. Additionally, 60 residential institution personnel are responsible for the caring of adolescent orphans. Tools: Five tools were used. Tool I: " Adolescent orphans' socio-demographic and profile structured interview schedule". Tool II:" Anthropometric measurements". Tool III: “Strength and Difficulties Questionnaire " (SDQ). Tool IV: " Residential institution personnel socio-demographic data questionnaire" Tool V: "Residential institution physical environment observation checklist" Results: More than one-quarter of institutionalized adolescents expressed that they need psychosocial care and recreational activities. Most of them had behavioral and peer problems. There were significant relations between adolescent perpetration of violence and sub-scales of SDQ as conduct problems. Conclusion: Adolescent orphans have many needs as psychosocial and recreational needs furthermore they suffer from health, psychosocial, and behavioral problems. Recommendation: Provide psychosocial counseling programs for resolving the psychosocial problems of orphans.