The aim of this study was to determine estimates of the prevalence and social correlates of physical fighting among adolescents in Caribbean countries. Cross-sectional national data from the Global School-based Health Survey (GSHS) included 11571 students primarily at the ages from 13 to 16 years from 7 Caribbean countries chosen by a two-stage cluster sample design to represent all students in Grades 6-10 in each country. Results indicate that, 28.6% of the adolescents had been in a fight 2 or 3 times or more in the past 12 months. Physical fighting was the highest in Jamaica (30.0%) and Antigua and Barbuda (29.8%) and the lowest in Dominica (21.1%) and St Lucia (23.3%). In multivariate logistic regression it was found that being male, risk behaviours (being bullied, smoking alcohol use and early sexual debut), suicide ideation and truancy were associated with physical fighting. Several clustering risk factors were identified which can be utilized in public health interventions.