They begin attending Eitoku Academy in kindergarten. The group gained control of the high school through fear mostly. Their classmates mindlessly followed their orders, while the teachers turned a blind eye.
"You strut around like peacocks...but you're really like the frog in the fable! You know your tiny little well, but nothing about the ocean beyond it! You're protected by your fathers' names! You've never had to work for anything you've got! So shut your beaks!"
By high school, the friends had formed an official group, known as the Flower 4 or F4. Tsukasa, as the de facto leader, became somewhat tyrannical during this time. They disregarded school rules by wearing regular clothes and often skipped school altogether. At some point, they began giving red cards, the F4's "declaration of war", to those who annoyed or opposed them. Tsukushi Makino became one of their victims, after she protected her friend.
Originally the F4 were suppose to be the "F5", when Yoko Kamio proposed the idea to her editor. However, while drawing the first color spread, she could only fit in four boys thus turning the "F5" to F4.
The F4 is portrayed by by Shosuke Tanihara, Naohito Fujiki, Kensaku Saeki, and Koichi Hashizume in the Hana Yori Dango film, their first live-action appearance. The group has a fan club in this version with a high membership fee. When Tsukushi refuses to join the club, Tsukasa gives her a red card and bullies her. Similar to the manga, Akira and Sojiro are given significantly less screen time than Tsukasa and Rui.
In the unauthorized Chinese adaptation, Meteor Shower the F4 was renamed "H4". The H4 are played by Hans Zhang (Murong Yunhai), Yu Haoming (Duanmu Lei), Zhu Zixiao (Shangguan Ruiqian), and Wei Chen (Ye Shuo). The circumstances and personalities of the group are changed for legal reasons since the producers did not obtain the rights to Boys Over Flowers. In the story, Shangguan Ruiqian, Ye Shuo, and Duanmu Lei attend Aliston College. Murong Yunhai transfers to the school and locks horns with the leader, Ruiqian. The four eventually become friends and unite under a common goal, making Yunhai the new leader.
The Indian television series, Kaisi Yeh Yaariaan, which was based on the Korean Boys Over Flowers changes the F4 to "Fab 5". Parth Samthaan (Manik Malhotra), Utkarsh Gupta (Dhruv Vedant), Charlie Chauhan (Mukti Vardhan), Ayaz Ahmed (Cabir Dhawan), and Krissann Barretto (Alya Saxena) play the Fab 5. The group could be considered the most unique rendition by adding one more member and three of the five members not having a clear counterpart. Samthaan and Gupta are the equivalents of Tsukasa and Rui, while Ahmed and Chauhan share characteristics with Akira and Sojiro. Barretto is distinctly original, being the girlfriend of Manik for part of the show.