Introduction: Excess use of digital devices and time spent with screens might negatively influence several lifestyle behaviors in adolescents which in turn can cumulatively increase the risk of obesity(1-3). A better understanding of these associations will help to focus interventions to improve present and future health outcomes of adolescents. We conducted this study to examine the associations of screen time with eating habits, physical activity levels, sleep patterns, and adiposity measures in a sample of 10-17 years old adolescents in Mumbai, India. Methods: Cross-sectional study design. Adolescents (n=772) were selected from six public and six private schools and two junior colleges using a stratified random sampling method. Screen time, physical activity levels, and sleep patterns were assessed using a researcher-designed screen time questionnaire, Physical Activity Questionnaire for Children and Adolescents (PAQ-C/-A), and Pittsburg Sleep Quality Index (PSQI) respectively. Two non-consecutive 24h diet recalls and a 35-item validated food frequency questionnaire determined the eating habits and energy and nutrient intakes. Body mass index (BMI) z scores > 1 and waist to height ratio (WHtR) > 0.5 were defined as measures of adiposity. Multivariate logistic regression models predicted the associations between screen time and lifestyle factors, stratified by sex. Results: The mean age of adolescents was 14.6 (2.4) years, 28.4% were overweight, 47.8% had WHtR > 0.5 and 76.1% reported their daily screen time to be > 2 hours. The PAQ scores were significantly higher in boys (p 0.032) and the mean sleep duration declined with age (p 2h/d was associated with unhealthy snack consumption (OR = 1.34, 95% CI = 1.03-1.72), lower fruit consumption (OR = 1.8, 95% CI = 1.54-2.01) and higher mean carbohydrate intakes (OR = 1.51, 95% CI = 1.44-1.67). The odds of insufficient sleep duration ( 2h/d and an overall screen time > 4 h/d predicted lower mean PAQ summary scores (OR = 4.1, 95% CI = 3.78-4.24). Attending private schools (OR = 1.63 (95% CI = 1.04-1.99), watching television while eating > 2h/d (OR = 1.34 (95% CI = 1.03-1.72) and having higher sleep related daytime dysfunction scores (OR = 1.25 (95% CI = 1.13-2.09) predicted higher WHtR. Additionally, being overweight was significantly associated with higher screen addiction scores (p < 0.001). Conclusion: In adolescents, excess screen time predicted unhealthy eating habits, reduced sleep duration, and greater adiposity. Results support a need to develop interventions targeted at reducing screen time to leverage better lifestyle behaviors and lower obesity risk in adolescents.