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Borderline personality disorder (BPD) has been conceptualized as a constellation of symptoms related to problems in self-functioning, emotion regulation, and interpersonal relationships. Its etiology has been connected to individuals’ early childhood environment, caregiving relationships, and traumatic life events. Recent literature has noted the potential presence of BPD beginning in adolescence, or even earlier in childhood. Attachment theory offers a lens for understanding the symptoms of borderline personality disorder and identifying potential aspects of treatment that may be specifically valuable for adolescent patients. Adolescence marks a time when the attachment system has increased relevance due to the importance of identity formation, peer relationships, body representations and the development of autonomy at this time, in the face of physical changes and academic challenges. This article will summarize research on attachment, body representations, personality disorders, and features of development in adolescence, in order to enhance clinical understanding of patients who presenting with these types of difficulties.