To review the epidemiology, confidentiality, and methods of abortion provision specific to adolescents. In the United States, four out of five pregnancies in teenagers are unintended and about one-third of all adolescent pregnancies end in induced abortion. Barriers such as travel and cost decrease abortion access for all women and adolescents, whose pregnancies are diagnosed later than older women, may be particularly impacted by such challenges. An increasing majority of states require parental involvement in adolescents' decisions to end their pregnancies. Recent analyses indicate that mandating parental involvement does not promote family communication; rather, such laws may actually increase the risk of harm by delaying appropriate medical care. Medication and surgical abortion are options for adolescents; both are safe and effective. There is no evidence that abortion during adolescence causes negative psychological consequences, decreased fertility, or increased risk in future pregnancies. Continued high rates of unintended pregnancy among US adolescents necessitate access to safe and timely abortion services. Unfortunately, teens encounter unique barriers in obtaining abortion care that lead to delays and preventable risk associated with later abortion.