Background <p>Mental health issues are increasingly prevalent among adolescents, particularly in rural areas of low-income countries where resources are limited and cultural norms often discourage help-seeking. This study explored barriers to accessing mental health care among rural adolescents in Gondar Zuria, Ethiopia.</p> Methods <p>A descriptive qualitative study design was used. Purposive sampling ensured variation across gender, residence, school attendance, and socioeconomic background. A total of 18 adolescents and 6 key informants participated in individual interviews, and 3 focus group discussions were conducted for validation. Data were collected using semi-structured guides and analyzed through inductive thematic analysis.</p> Results <p>Four major themes were identified: (1) limited awareness and misconceptions about mental health, (2) family-level barriers including low parental support and financial constraints, (3) community and societal barriers such as stigma and reliance on traditional practices, and (4) health system barriers including lack of services and inadequate training of health workers. These multi-level factors collectively constrained adolescents’ access to mental health care.</p> Conclusions <p>Rural adolescents in Gondar Zuria face substantial structural, socio-cultural, and individual-level barriers to mental health care. Policy-makers should prioritize integration of adolescent mental health services into schools and primary health care, strengthen the capacity of health workers, and implement culturally sensitive awareness and anti-stigma initiatives.</p>