School absenteeism is a multifaceted and widespread issue during adolescence, often associated with psychological maladjustment, academic failure, and social difficulties. According to Self-Determination Theory, the frustration of basic psychological needs (autonomy, competence and relatedness) can undermine motivation and engagement. However, few studies have explored how these psychological needs relate to distinct profiles of school absenteeism based on multidimensional frameworks such as the Assessing Reasons for School Non-Attendance (ARSNA; Havik et al., 2015). This study aimed (1) to identify latent profiles of school absenteeism based on the four ARSNA dimensions (somatic symptoms, subjective health complaints, truancy, and school refusal), and (2) to examine whether these profiles differ in students’ perceived autonomy and competence across general, academic, interpersonal, and leisure life domains. A sample of 1,130 Spanish adolescents (Mage = 14.85, SD = 1.83) completed the Assessing Reasons for School Non-Attendance, the Perceived Autonomy in Life Domains Scale, and the Perception of Competence in Life Domains Scale. Latent Profile Analysis and Multivariate Analysis of Variance (MANOVA) were conducted to identify school absenteeism profiles and examine intergroup differences. Three profiles emerged: Non-School Absenteeism, Moderate School Absenteeism, and High School Absenteeism. The High School Absenteeism profile reported significantly lower levels of perceived autonomy and competence across all domains, particularly in academic and leisure contexts. The High School Absenteeism profile showed significantly lower levels of perceived autonomy and competence across all domains compared to the other profiles, with the largest differences observed in academic and leisure domains.