The United States has the highest rate of teen pregnancy in the Western world. Although abstinence may be the ideal solution for the prevention of this problem, one half of adolescents in the United States are sexually active. This article reviews the epidemiology of contraception among adolescents, barriers to effective use of contraception, and ways to improve efficacy. Major methods of contraception, including oral contraceptive pills, Norplant, Depo-Provera, condoms, spermicide, sponge, intrauterine device (IUD), diaphragm, and rhythm/periodic abstinence, are discussed along with method-specific issues related to adolescents.