Objective: This study aimed to identify health risk behaviors contributing to academic performance while controlling for other factors and investigated the relationship between academic performance and multiple simultaneously occurring predictors among public high school students in Rhode Island. Methods: The Youth Risk Behavior Survey (YRBS) is conducted in a representative sample of public school students in grades 9-12 using a two-stage cluster sample design. In the springs of 2007, 2009, and 2011 a total of 9,384 adolescents participated in Rhode Island’s statewide YRBS. The data were analyzed with multinomial logistic regression. Results: Students who had been in a physical fight (past 12 months), were ever hit/slapped by a boyfriend/girlfriend, felt sad/hopeless for 2+ weeks (past 12 months), were current smokers (past 30 days), were current marijuana users (past 30 days), ever had sexual intercourse, perceived themselves as overweight, had insufficient physical activity (less than 60 minutes per day, 5 days per week), or played video games 3+ hours per school day were more likely to self-report obtaining low grades than students without these risk behaviors. Poor academic achievers are more prevalent among students of both sexes who participate in high-risk behaviors even after adjusting for other confounding effects. Conclusions: Poor academic achievement in school may be a good indicator of students who are at risk of engaging in unhealthy or dangerous behaviors and in need of support or intervention. Conversely, prevention strategies aimed at risk behaviors may enhance student academic achievement.