Background: Molar Incisor Hypomineralization (MIH) is a developmental enamel defect affecting permanent first molars and incisors, presenting significant challenges in pediatric and adolescent dental care. The condition has gained considerable attention due to its increasing prevalence and substantial impact on oral health-related quality of life. Objective: This cross-sectional study aimed to determine the prevalence of MIH among adolescents aged 12–16 years and evaluate its clinical impact on oral health parameters and quality of life. Methods: A total of 847 adolescents from eight secondary schools were examined using the European Academy of Paediatric Dentistry (EAPD) criteria for MIH diagnosis. Clinical examinations assessed caries experience (DMFT index), dental sensitivity, and treatment needs. The Child Oral Health Impact Profile (COHIP) questionnaire evaluated oral health-related quality of life. Statistical analyses included chi-square tests, t-tests, and logistic regression, with significance set at p<0.05. Results: The overall MIH prevalence was 14.8% (n=125). Among affected individuals, 68.0% exhibited mild MIH, 23.2% moderate, and 8.8% severe forms. Adolescents with MIH demonstrated significantly higher mean DMFT scores (3.87 ± 2.14) compared to unaffected peers (2.21 ± 1.76; p<0.001). Dental sensitivity was reported by 72.8% of MIH-affected participants versus 18.4% of controls (p<0.001). COHIP scores indicated significantly poorer oral health-related quality of life in the MIH group (p<0.001). Conclusion: MIH demonstrates considerable prevalence among adolescents and significantly impacts oral health outcomes, caries susceptibility, dental sensitivity, and quality of life. Early identification and comprehensive management protocols are essential for optimizing outcomes in affected individuals.