Introduction: The relationship between the Rating of Perceived Exertion (RPE) and well-being in adolescent athletes is controversial, complicating effective athlete monitoring. This meta-analysis aimed to clarify this relationship and investigate the critical moderating role of well-being dimensions. Methods: Following the PRISMA guidelines, we systematically searched the Web of Science and PubMed, including 24 studies (57 effect sizes). Results: An initial analysis of the overall relationship revealed extremely high heterogeneity (I2= 85.6%), indicating that pooling all well-being dimensions is inappropriate. Subgroup analysis was decisive, identifying the nature of the well-being indicator as the key moderator. The RPE was strongly positively correlated with consumptive indicators (e.g., fatigue, delayed onset muscle soreness (DOMS); r = 0.51) but moderately negatively correlated with restorative indicators (e.g., sleep quality; r = -0.45), with the difference between these groups being highly significant (p < 0.0001). Sport type, age, and gender were not significant moderators. Although publication bias was detected (p = 0.014), sensitivity analyses confirmed the robustness of the crucial subgroup findings. The generalizability of these results may be limited as the included samples predominantly consisted of elite, male adolescent athletes. Conclusion: In conclusion, the RPE-well-being relationship is profound but context-dependent, driven by the nature of the well-being metric (consumptive vs. restorative). This provides a scientific basis for more precise athlete monitoring. Systematic review registration: CRD420251138178, https://www.crd.york.ac.uk/PROSPERO/view/CRD420251138178.
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