Pediatricians have an important role in adolescent reproductive health care. Their long-term relationships with patients and families allow them to help promote healthy decision-making around sexuality and include abstinence as a way to avoid the negative consequences associated with risky sexual behaviors. As advocates for the health and well-being of young people, pediatricians communicate their recommendation to adolescent patients to postpone sexual activity until they are ready, because any sexual activity for which the adolescent is ill prepared may have emotional, physical, and financial consequences. However, clinicians recognize that some of their adolescent patients are sexually active or will choose to become so. Recent studies indicate that, for some adolescents, even participating in formal programs that advocate abstinence and signing abstinence pledges do not result in abstinent behavior.1,2 Pediatricians can have an active role in encouraging their adolescent patients to use contraception to reduce the risk of unintended pregnancies and to prevent sexually transmitted infections (STIs). In previous publications, the American Academy of Pediatrics (AAP) has addressed issues of adolescent sexuality, unwanted pregnancy, STIs, and contraception.3 This policy statement provides the pediatrician with updated information on adolescent sexual behavior, which may lead to pregnancy, including guidelines for counseling adolescents about available methods of contraception. Current methods available are discussed, as are methods in development.