This report begins with a situation analysis of adolescent pregnancy (Section 2), highlighting where today’s adolescents live and where their fertility levels are highest, as well as looking at the drivers of their fertility rates. Section 3 provides a more detailed discussion of the multiple barriers that girls face in controlling their fertility. Section 4 presents our conclusions about the main drivers of adolescent pregnancy and introduces our policy and programming recommendations, which can be found in Section 5. Our recommendations for reducing adolescent pregnancy include “quick wins” as well as medium and longer-term solutions that address both the proximate and distal causes of early fertility. A detailed recommendations table that offers specific good practice examples from throughout the developing world can be found, along with full methodological details, in the companion Supplementary Materials file.