Background <p>Premarital sexual behavior among adolescents remains a sensitive public health concern in conservative societies, where cultural and religious norms strictly regulate sexuality. Despite these limitations, risky behaviors persist and are influenced by environmental, familial, and media factors.</p> Objective <p>This review aimed to identify and synthesize factors related to premarital sexual behavior among adolescents in conservative societies using the Theory of Planned Behavior (TPB) as a guiding framework.</p> Methods <p>A scoping review was conducted according to The 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines. Relevant studies were identified in PubMed, Scopus, Cochrane, and EBSCOhost, focusing on adolescents aged 10–24 years in conservative settings. The data were analyzed thematically based on the following TPB components: attitudes, subjective norms, and perceived behavioral control.</p> Results <p>Twenty-three studies met our inclusion criteria. The factors influencing premarital sex include religiosity, peer pressure, exposure to pornography, parental supervision, and substance use. Religiosity and family communication act as protective factors, whereas exposure to pornography and peer influence increases risk.</p> Conclusion <p>Premarital sexual behavior among adolescents in conservative societies is shaped by individual attitudes, social norms, and perceived control. Culturally sensitive sex education programs, digital literacy, and family involvement are recommended to promote safer behaviors.</p>