The first pelvic examination is often an emotionally charged and stressful event in the adolescent patient. The female adolescent patient has many unique health care needs, which if not met, can negatively impact future gynecologic health. History taking and physical examination techniques specific to the adolescent female patient are discussed. Indications for pelvic examination along with practice tips in communicating with the adolescent female patient are reviewed. Methods of reducing patient anxiety and empowering the adolescent to take charge of her health are discussed.