The positive health trends and overall improvement in health status among the US population cause health professionals, human service providers, educators, and policy makers to be encouraged about the fitness of our nation. When taking a closer look at these trends and related changes, however, a dilemma exists among a portion of our population that cannot be dismissed. While the health status of the US population as a whole has steadily improved over the past decades, such progress has not been sustained for adolescents. In fact, adolescence (15 to 21 years of age) is the only age group in which mortality rates have increased over the past decade.One of the principal threats to adolescent health is unwanted pregnancy. More than one million teenage pregnancies occur each year in the United States, 75 percent of which are unintended. Teenage pregnancy is a multifaceted problem that requires multifaceted intervention. It is not just the pregnant teenager's problem either, but may involve up to three generations of family members and a host of other significant relationships. The impact and cost to society can become staggering.If such a great proportion of these pregnancies are unintended, what steps can be taken to offer acceptable and accessible alternatives to adolescents? An assessment of the magnitude of this problem, its impact on the family and society, and the measures implemented to date reveal a major challenge facing our policy makers, health and human service providers, and concerned citizenry.