Adolescent contraception is an essential public health priority amid rising sexual activity and declining condom use. One in five high schoolers is sexually active, with only one-third using non-barrier contraceptive methods. Unintended pregnancies and STIs pose significant risks to young people: disrupting school attendance and contributing to short- and long-term socioeconomic burdens. This chapter explores contraception with attention to teen sexual development—from hormonal shifts and peer pressures to cultural stigmas—while emphasizing patient-centered counseling that prioritizes confidentiality, autonomy, and reproductive justice. Tailored strategies, including motivational interviewing and myth-busting around long-acting reversible contraceptives (LARCs) increase adherence and satisfaction. Special considerations include evidence-based updated information around contraceptive concerns: weight gain, mood effects, and fertility concerns. Equitable access to comprehensive sex education—in addition to personalized and confidential contraception counseling with same-day options—empowers adolescents to make informed reproductive decisions, build healthier futures, and pursue their education and career goals.