Background <p>The developmental trajectory among Chinese adolescents remains unclear. This study aimed to explore the developmental trajectory of school refusal behavior and examine how individual and environmental factors predict this trajectory among Chinese adolescents.</p> Participants and methods <p>A longitudinal design was used with 1,308 middle and high school students (<i>mean</i>_age ± <i>SD</i>_age = 14.35 ± 1.50, 41.36% boys) who were followed up across three time points (T1, T2, and T3) over one year.</p> Results <p>The latent growth mixture model analysis (LGMM) revealed four subgroups within the developmental trajectory of school refusal behavior among Chinese adolescents: a low-decrease group (<i>n</i> = 678), a high-stable group (<i>n</i> = 445), a high-decrease group (<i>n</i> = 104), and a low-increase group (<i>n</i> = 81). Furthermore, group membership was predicted by academic resilience, family functioning, and class interpersonal harmony.</p> Conclusions <p>These findings suggest that effective interventions are needed to address the various developmental trajectories of school refusal behavior in adolescents.</p>