Introduction: Family and school environments are pivotal in adolescent development. However, the simultaneous examination of adversities in both domains remains understudied. Based on bioecological and spillover theories, this study aimed to bridge this research gap by using latent profile analysis to identify distinct patterns of family adversity and bullying involvement among Chinese adolescents. This study also explored mental health problems associated with these patterns. Methods: This study was conducted in June (T1) and December (T2) 2023, with a 6-month interval, in Henan Province, China, and involved 2,568 adolescents (50.3% girls, M[subscript age] = 13.46 ± 0.72). Participants completed questionnaires assessing family adversity and bullying involvement at T1, as well as assessments of depressive symptoms, anxiety symptoms, suicide risk, and complex posttraumatic stress disorder symptoms at both T1 and T2. Results: Six profiles were identified--low adversity and bullying (69.0%, n = 1,771), abuse only (10.9%, n = 279), neglect only (4.5%, n = 115), bullying involvement only (3.7%, n = 96), moderate adversity and bullying with severe abuse (6.9%, n = 176), and moderate adversity and bullying with severe neglect (5.1%, n = 131). Importantly, the severity of mental health problems varied significantly across these profiles. Conclusion: The study enriches our understanding of concurrent family adversity and bullying involvement and their impact on adolescent mental health, offering insights for tailored intervention strategies for affected groups.