We undertook this study to provide empirically derived interpretative recommendations for the MMPI-A Structural Summary through an evaluation of factor elevation patterns. We examined the frequency of single-factor, two-factor, and multifactor elevations in a clinical sample of 363 adolescents receiving inpatient, outpatient, or residential treatment. Two methods of determining factor elevation (a simple majority of scales and subscales within a specific factor with T-score elevations at critical level, versus the mean T score generated by all the scales and subscales for each factor) yielded comparable findings concerning the frequency of factor elevation, permitting reliance on the former, easier-to-use method to define elevation. The most salient two-factor co-elevations were the 3-7 (Disinhibition-Familial Alienation), 2-8 (Immaturity-Psychoticism), 1-5 (General Maladjustment-Health Concerns), and 2-7 (Immaturity-Familial Alienation) patterns. This study also examined whether factor pattern elevations varied as a function of age, gender, or diagnosis. Data analyses revealed no differences between younger (ages 13-14) and older (ages 15-18) adolescents on factor elevation as defined by the first criterion. However, significant differences were found between boys and girls on Factors 3 (Disinhibition) and 5 (Health Concerns). Results also indicated that a larger proportion of depressed adolescents obtained factor elevations on Factors 4 (Social Discomfort) and 5 (Health Concerns) compared to adolescents with conduct disorder diagnoses and other diagnoses. The findings of this study are discussed with reference to recommended procedures for using the Structural Summary in clinical assessment practice.