Aim <p>The use of pharmaceutical stimulants without a medical prescription (PSWMP) is an important public health issue, especially among adolescents. Given the important negative consequences on youth health and well-being, continuous monitoring and analysis of the phenomenon through representative and reliable data is critical. The purpose of this study is to provide national estimates of the prevalence of PSWMP use among students aged 15–19&#xa0;years and to analyse gender differences.</p> Subject and methods <p>Data were collected from 16 consecutive waves of the ESPAD^® Italia study (from 2008 to 2023), and all the samples were representative of the Italian student population.</p> Results <p>Fluctuations were observed in the lifetime prevalence trend (male: from 1.4% to 5.8%; female: from 2.9% to 8.0%) as well as use in the last year (male, 0.9–3.3%; female, 1.5–4.1%), last month (male, 0.7–2.2%; female, 0.7–2.4%), and frequent use (male, 0.1–0.9%; female, 0.1–0.6%).</p> Conclusion <p>The prevalence trend showed fluctuations, and clear gender differences were found in the prevalence of consumption. Over the past 17&#xa0;years, PSWMP consumption has not increased.</p>