The versatile construct of perfectionism has been heavily debated, e.g., its nature or measurement constituents, how it influences performances or, most importantly, our health. Conventional linear analyses seem inadequate to address such challenges. Hence, we used a latent variable and a person-centered approach to identify different patterns of perfectionism, and their relationships with psychological health as outcome among early adolescents (13-14 years) attending conventional or elite sports-/performance-oriented lower secondary schools (14 schools, 832 students, 53% girls). All students completed two perfectionism scales, i.e., the child-adolescent perfectionism scale (CAPS) and the frost multidimensional perfectionism scale (FMPS). The criterion-related variables of psychological health included anxiety, depression, eating disorder problems, self-worth and resilience, respectively. Exploratory and confirmatory factor analyses yielded a four-factor representation of perfectionism. Using latent class analysis extracted five profiles of perfectionism, which were related to the criterion variables. Three profiles were clear indicators of either low or high perfectionism score patterns. Two profiles showed a mixed picture of high and low scores, whereas one represented a psychological healthy subgroup. About four of ten adolescents in the ordinary schools matched the two most debilitating perfectionism profiles compared to two of ten in the elite schools. How these results align with international findings is discussed along with the relevance for early interventions aimed at preventing the potential downsides of perfectionism. Longitudinal studies are neeed to explore profile trajectories as well as possible health consequences.