This systematic review examines the empirical evidence supporting dual-factor models of mental health, which propose that mental health consists of two interrelated yet distinct dimensions: psychopathology and well-being. The review analyzed 85 studies published between 2001 and 2023, focusing on psychometric evidence and variables associated with different mental health groups. The results show that the dual-factor model is supported by factorial evidence, with two independent but related factors: positive mental health and mental illness. The most prevalent mental health group is the Complete Mental Health group, characterized by high well-being and low psychopathology. Other groups include Symptomatic but Content (high well-being and high psychopathology), Vulnerable (low well-being and low psychopathology), and Troubled (low well-being and high psychopathology). Longitudinal studies indicate that most participants remain in the same group over time, with the Complete Mental Health group being the most stable. Factors associated with mental health status include school-related outcomes, supportive relationships, sociodemographic characteristics, psychological assets, individual attributes, physical health, and stressful events. The Complete Mental Health group showed the highest levels of academic performance and engagement, while the Troubled group showed the worst results. The Symptomatic but Content group showed results more similar to the Complete Mental Health group than the Troubled group. Supportive relationships were consistently reported as higher in the Complete Mental Health group. Individual variables such as personality, locus of control, and psychological assets were also associated with mental health outcomes. The review highlights the importance of considering both psychopathology and well-being when conceptualizing, operationalizing, and measuring mental health. Practitioners should include well-being-related interventions in their practice to improve mental health outcomes. The review also suggests that further research is needed on cross-cultural evidence, longitudinal studies, and the role of trauma and stressful experiences in mental health. The findings emphasize the complexity of mental health trajectories and the need for interventions that address both psychopathology and well-being.This systematic review examines the empirical evidence supporting dual-factor models of mental health, which propose that mental health consists of two interrelated yet distinct dimensions: psychopathology and well-being. The review analyzed 85 studies published between 2001 and 2023, focusing on psychometric evidence and variables associated with different mental health groups. The results show that the dual-factor model is supported by factorial evidence, with two independent but related factors: positive mental health and mental illness. The most prevalent mental health group is the Complete Mental Health group, characterized by high well-being and low psychopathology. Other groups include Symptomatic but Content (high well-being and high psychopathology), Vulnerable (low well-being and low psychopathology), and Troubled (low well-being and high psychopathology). Longitudinal studies indicate that most participants remain in the same group over time, with the Complete Mental Health group being the most stable. Factors associated with mental health status include school-related outcomes, supportive relationships, sociodemographic characteristics, psychological assets, individual attributes, physical health, and stressful events. The Complete Mental Health group showed the highest levels of academic performance and engagement, while the Troubled group showed the worst results. The Symptomatic but Content group showed results more similar to the Complete Mental Health group than the Troubled group. Supportive relationships were consistently reported as higher in the Complete Mental Health group. Individual variables such as personality, locus of control, and psychological assets were also associated with mental health outcomes. The review highlights the importance of considering both psychopathology and well-being when conceptualizing, operationalizing, and measuring mental health. Practitioners should include well-being-related interventions in their practice to improve mental health outcomes. The review also suggests that further research is needed on cross-cultural evidence, longitudinal studies, and the role of trauma and stressful experiences in mental health. The findings emphasize the complexity of mental health trajectories and the need for interventions that address both psychopathology and well-being.