The United States continues to have the highest rate of adolescent pregnancy in the western industrialized world. This review focuses on the recent decline in adolescent pregnancy rates and the recent slight decline in the number of sexually experienced youths. Risk factors for adolescent pregnancy, such as history of forced sexual intercourse and lack of connectedness with parents, are discussed. Various strategies to decrease the adolescent pregnancy rate and the effectiveness of these strategies are reviewed. The unique role of the primary health care provider in the prevention of adolescent pregnancy is also addressed.