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Adolescence is a formative time of transition to adulthood. What happens between the ages of 10 and 19 shapes how girls and boys live out their lives as women and men—not only in the reproductive arena, but in the social and economic realm as well. Yet, despite its impact on human development, adolescence has been sidelined as a research and policy subject in developing countries. While all adolescents deserve our attention, the needs of adolescent girls in the developing world are particularly pressing. This monograph focuses on these girls, presenting statistics to examine the social and economic context of their lives at home, school, and work, and to investigate adolescent reproductive health, marriage, and childbearing. Distinctive features of adolescent girls’ lives include confinement to domestic roles; restricted mobility; inadequate schooling; insufficient opportunities to work for wages; pressure, in many countries, to marry early and to begin childbearing immediately after marriage; and limited control over their reproductive health and fertility. This monograph outlines an agenda for policy, programs, and research, and provides illustrations of successful local efforts to improve the lives of adolescents.