Cancer in adolescents is rare with approximately 600 adolescents being diagnosed with cancer in the UK each year. With such small numbers, clinical trials are imperative if improvements in treatment and prognosis are to be achieved. However, the availability of such trials and the issues surrounding clinical trials in adolescents with cancer has rarely been reviewed. There are a number of issues regarding clinical trials that are particularly pertinent to this group. Primarily, despite evidence that adolescents with cancer fare better when treated on clinical trials, it would appear that adolescents do not have equal access to trials because of the fragmentation of adolescent cancer care between adult and paediatric oncology. For those who are treated within clinical trials, issues of informed consent need to be addressed, such as who should give consent and the provision of age-appropriate information. Finally, it has been suggested that adolescents are less compliant with treatment than both their adult and paediatric counterparts. As many adolescents with cancer can now been cured, this should be an area of great concern and more research is needed to ascertain the full extent of the problem and ways of overcoming it. The availability of clinical trials, along with the issues surrounding clinical trials in adolescents, need to be addressed if continued improvements in the outcome of this group of patients are to be seen.