Adolescents in Africa are the world's fastest growing population group. Despite escalating rates of mental health disorders, little is known regarding the role of protective mechanisms that characterise resilience in adolescent mental health globally and in Africa, where there is heightened exposure to adversities. This study draws on two waves of a longitudinal population cohort from a peri-rural setting in KwaZulu Natal South Africa to investigate the relationship between grit - as a psychological resilience factor - and mental health outcomes in adolescents (N = 1174). Heightened mental health difficulty ratings for internalising factors were found across two study waves, with females reporting significantly higher rates of depression. Grit was found to be significant predictor of lower adolescent depression and anxiety, but dependent on the severity of internalising symptoms, sociodemographic factors and exposure to socioeconomic adversity. Potential differences in the mechanisms of adolescent resilience are highlighted that involve a dynamic interplay between bottom-up and top-down resilience factors in the African context.