Paediatric and adult healthcare services approach adolescents and young adults (AYA) differently; but whether located in adult or paediatric services, AYA healthcare should remain consistent with the key principles underpinning the practice of adolescent medicine and responsive to the changing needs of AYA. All rheumatology services should recognise AYA as a distinct patient group with unique healthcare and psychosocial needs. AYAs require treatment within their wider psychosocial context, taking into account the life changes and transitions that shape this stage of development. Flexible, person-centred developmentally appropriate healthcare, peer support and knowledge and skills training are important for this group of individuals for whom feeling “normal” is of major importance. This chapter highlights the importance of ensuring that AYA rheumatology services are both developmentally appropriate and youth-friendly; outlines the key characteristics of such services, including some examples on how to translate them into practice; and discusses some implementation and training considerations.