This study explored factors associated with differential patterns of social and health service use among pregnant and parenting African American adolescents. One hundred seventy-seven young women between the ages of 14 and 22 took part in the study. Cluster analysis suggested three groups of users: frequent users, moderate users, and inconsistent users. These groups were distinct in terms of their frequency of service usage, perceptions of barriers to usage, and psychological and social functioning. Moderate users appeared to be healthier than either the frequent or inconsistent users, as indicated by their relatively higher levels of psychological functioning. In contrast, inconsistent users were distinguished by their high rates of sexual victimization, their low use of medical services, and their perceptions of many programmatic and personal barriers to usage. Suggestions for research and interventions that encompass the diverse needs of young African American women are made.