OBJECTIVE To examine factors associated with long-term involvement of the fathers of children born to adolescent mothers receiving health care in a teen-tot clinic. METHODS Ninety-three first-time adolescent mothers younger than 18 years receiving care in a hospital-based teen-tot clinic participated in standardized structured interviews at 2 weeks and 24 months post partum. Data were obtained on demographic factors, the father's prenatal and delivery involvement, frequency of the father's contact with his child, and his participation in child care and financial support of the child. RESULTS Factors associated with at least monthly contact between father and child during the first 24 months of the child's life were attending at least one prenatal visit, seeing the newborn in the hospital, and a reported supportive relationship between the young mother's family and the father at the 2-week interview. Age of the father and his education, work, or living arrangement did not predict involvement at 24 months. CONCLUSIONS Our study suggests an association between a father's active participation in both the prenatal and neonatal periods and later contacts between children of adolescent mothers and their fathers. Since other studies indicate that paternal involvement results in more effective maternal parenting and satisfaction, interventions that encourage fathers' participation in both prenatal and intrapartum care should be developed and rigorously evaluated.