Alexithymia (“no words for feelings”) is a personality construct characterized by an inability to identify, describe, and verbalize one's feelings, constricted imagination, and an externally oriented way of thinking. Alexithymia is commonly measured with self-report instruments. Data, in particular from Asian countries, regarding the epidemiology of alexithymia in adolescents are relatively limited. The objectives of this study were to examine the prevalence and explore the relationship between alexithymia, family emotional expressiveness, parental acceptance-rejection, and depression. A total of 1606 Chinese adolescents aged between 10 and 17 years old were recruited from 11 schools across the three major geographical regions of Hong Kong. A self-report questionnaire was administered. About 36% of adolescents were classified as alexithymic in the whole sample (males: 34.3%, females: 40.0%) and no gender differences were found. Adolescents with lower family emotional expressiveness and depression were more likely to report alexithymia. The alexithymia rate among Chinese adolescents was higher than in most of the existing studies. The association of alexithymia with diminished family emotional expressiveness underscores the relevance of targeting adolescents with low family emotional expressiveness, and depressive symptoms to increase their capacity to identify and communicate emotions in order to improve their psychological well-being. Copyright © 2020 Elsevier B.V. All rights reserved.