Background: Self-rated health (SRH) in adolescence is known to be associated with health outcomes in later life. We carried out a trend analysis on data coming from three waves of data collected in 32 countries (mostly European) from 2002 to 2010 coming from the Health Behaviour in School-Aged Children surveys. Methods: SRH in adolescents was assessed using a Likert scale (excellent, good, fair and poor). Responses were dichotomized into ‘excellent’ vs. ‘rest’. Country, age and gender groups were compared based on the odds ratio of declaring excellent SRH in 2010 with respect to 2002 and 2006. Results: The trend for European adolescents indicates an improvement over the last decade, although, in the majority of countries, a higher proportion of adolescents rate their health as excellent during the period 2002–06 with respect to the second half of the decade (2006–10).Girls were found to constantly rate their health as poorer, compared to their male peers, in all countries. Age has also a very stable trend towards a decreasing rating of health with increasing age. Conclusion: Decreased rating of health in the period 2006–10 may be a signal of the socio-economic difficulties of Europe in the last part of this decade.