Adolescent pregnancy is an international dilemma affecting not just the adolescent and her infant, but entire societies. Of almost 300 million female adolescents worldwide, 16 million give birth yearly, accounting for 11% of all births worldwide. The Millennium Development Goal # 5 incorporates reducing adolescent births worldwide. The purpose of this paper is a comprehensive critique of findings on a global perspective on adolescent pregnancy and evaluation of strategies to reduce this international concern. In Latin America and the Caribbean, unmet need for family planning made little change in 20 years. In Dutch and Scandinavian countries, there are national sex education programmes and family planning clinics run by nurse midwives with direct authority to prescribe contraceptives. In Japan, strong conservative norms exist about premarital sex. In the UK, a lack of consistent targeted sex education, delay in access to contraception and contraceptive use failure are associated with high teen pregnancy rates. In the United States, 750 000 teen pregnancies occur yearly, costing $9 billion per year. Health disparities exist: Whites had 11, Blacks had 32 and Hispanics had 41 per 1000 births. Programmes to reduce teen pregnancy should incorporate family, contraception and abstinence education, and sustained commitment of media, businesses, religious and civic organizations.