Background: Adolescents and young adults (AYA) represent one third of patients affected with Hodgkin lymphoma (HL). Clinical presentation at diagnosis differs among some subgroups of patient: children, adults, elderly, and patients with immunodeficiency. However, specific features of HL in AYA remain unclear. We conducted a single-center study to describe the characteristics of HL in AYA and to define associated factors with disease progression and/or death. Methods: All consecutive patients newly diagnosed with HL were prospectively recruited before the initiation of treatment from one tertiary academic center (Saint Louis Hospital, Paris, France). Clinical characteristics and outcomes of patients aged from 15 to 25 years old were retrospectively computed. The primary endpoint was the occurrence of an event defined as progression of the disease or death from any cause. June 2005 was chosen as threshold for the analysis as it constitutes the advent of TEP-TDM in current practice. Uni- and multivariate survival analyses were performed using a Cox model. Results: 349 patients were included between 1979 and 2013, with a median follow-up of 7 years. Nodular sclerosis was the most representative histologic subtype (86.3%). According to Ann Arbor classification, patients had a disseminated disease in 45 % of cases. 289 (83%), 97 (28%) and 140 patients (56%) had a mediastinal lymph node, a bulky mediastinum and an extra-nodal involvement, respectively. No significant difference in terms of clinical presentation was noticed between patients younger than 21 year-old compared to older, except a more frequent EBV association after 21. Patients diagnosed after June 2005 presented more frequently a disseminated disease (36 % vs. 46.2 %, p = 0.04). 10 year-event free survival rate was estimated at 81% (95CI [76,7-85,5]). The first cause of mortality was HL. In multivariate analysis, stage 3 and 4 according to Ann Arbor classification were independently associated with the occurrence of event. Conversely, nodular sclerosis subtype was associated with a favourable outcome. Conclusion: Our large prospective cohort revealed interesting features of HL in AYA. Considering data from the literature, our study suggests a more frequent mediastinal involvement and a more advanced stage of disease in AYA compared to children and adults. Despite these pejorative features, relapse rate and mortality rates remain low.