Objective: A burgeoning body of evidence suggests a higher prevalence of autistic traits among individuals with misophonia. This study aimed to examine the comorbid psychiatric diagnoses and autistic traits along with associations between sensory profiles and internalizing symptoms in a clinical sample of adolescents with misophonia, while also comparing them to a control group. Method: Female adolescents with misophonia (n = 22) and controls (n = 22) aged 14-18 years participated in this study. Psychiatric evaluations were conducted with semi-structured interviews. The diagnosis of misophonia was established both clinically and through the use of the Amsterdam Misophonia Scale Revised. Autistic traits were assessed by the Youth Self Report. The Revised Children's Anxiety and Depression Scale-Child Version and the Adolescent/Adult Sensory Profile were administered. Results: The misophonia group exhibited a high prevalence of psychiatric diagnoses, particularly obsessive-compulsive disorder (OCD) and anxiety disorders. Adolescents with misophonia had a significantly higher level of internalizing symptoms, autistic traits, and sensory sensitivities (p<0.001, r=0.58; p<0.01, d=1.02; and p<0.001, r=0.58, respectively). Autistic traits had a mediating role in the relationship between misophonia and sensory sensitivity. Discussion: These findings suggest that evaluating autistic traits may offer valuable insights into understanding and managing misophonia in female adolescents, opening up avenues for the development of targeted interventions aimed at mitigating the impact of misophonia-related sensory sensitivity outcomes.