OBJECTIVE Positive youth development (PYD) may be a promising strategy for promoting adolescent health. A systematic review of the published data was conducted to identify and describe PYD programs that improve adolescent sexual and reproductive health. METHODS Eight databases were searched for articles about PYD programs published between 1985 and 2007. Programs included met the following criteria: fostered at least one of 12 PYD goals in multiple socialization domains (i.e., family, school, community) or addressed two or more goals in at least one socialization domain; allocated at least half of the program activities to promoting general PYD outcomes (as compared with a focus on direct sexual health content); included youth younger than 20 years old; and used an experimental or quasi-experimental evaluation design. RESULTS Thirty programs met the inclusion criteria, 15 of which had evidence of improving at least one adolescent sexual and reproductive health outcome. Program effects were moderate and well-sustained. Program goals addressed by approximately 50% or more of the effective programs included promoting prosocial bonding, cognitive competence, social competence, emotional competence, belief in the future, and self-determination. Effective programs were significantly more likely than those that did not have an impact to strengthen the school context and to deliver activities in a supportive atmosphere. Effective programs were also more likely to build skills, enhance bonding, strengthen the family, engage youth in real roles and activities, empower youth, communicate expectations, and be stable and relatively long-lasting, although these differences between effective and ineffective programs were not statistically significant. CONCLUSIONS PYD programs can promote adolescent sexual and reproductive health, and tested, effective PYD programs should be part of a comprehensive approach to promoting adolescent health. However, more research is needed before a specific list of program characteristics can be viewed as a "recipe" for success.