This study is a descriptive review of the effectiveness of initiatives to improve adolescent access to and utilization of reproductive health services (RHS) in low- and middle-income countries. We examined four RHS intervention types: (1) facility-based, (2) out-of-facility based, (3) interventions to reach marginalized or vulnerable populations, (4) interventions to generate demand and/or community acceptance. Results suggest weak but positive effects for approaches that use a combination of health worker training, adolescent-friendly facility improvements, and broad information dissemination via the community, schools, and mass media; no effect of out-of-facility–based strategies, especially for those delivered through mixed-use youth centers that “demonstrated that RHS in these centers are neither well used nor effective at improving SRH outcomes”; positive if mixed effects for demand-generation activities; and positive effects for efforts focused on increasing approval among gatekeepers. The authors conclude that “packages of interventions that train health workers, improve facility adolescent friendliness, and endeavor to generate demand through multiple channels” are likely to be most successful (2015).