This study explored adolescent females' experiences of social physique anxiety (SPA) and related coping strategies. A final sample of 31 adolescent females ages 13 to 18 years discussed dealing with SPA during individual semistructured interviews. Resultant themes pertaining to the transactional experiences of SPA were coded using content analysis. There were 107 unique coping strategies reported, which were coded into 10 subthemes. The main coping categories included behavioral and cognitive avoidance, appearance management, diet, social support, physical activity, reappraisal, cognitive deflection and comparison to others, seeking sexual attention, and substance use. Informed by a stress and coping framework, it is evident that body-related thoughts and emotions are linked to various adolescent health behaviors. (Contains 1 figure and 1 note.)