PYD has tremendous potential to promote not only ASRH but adolescent health more broadly. This review has identified 15 tested, effective models that have demonstrated impact on ASRH; most also affected other youth outcomes, and several produced long-lasting, sustainable effects. These model programs should be prepared for broader dissemination, replication, and effectiveness trials. Broader dissemination will entail investments in developing training, technical assistance, and monitoring models that will aid in ensuring and sustaining implementation with fidelity and tracking program adaptations in broad settings. Evaluations of existing national youth-serving organizations and existing PYD programs that are unevaluated should be encouraged if they are evaluable, address the most strongly supported PYD constructs, have a clearly developed logic model that connects program elements to youth development constructs and outcomes, and program manuals are developed. Support is also provided here for the impact of youth development constructs on later ASRH outcomes, suggesting that new PYD programs, especially those targeting PYD constructs with longitudinal evidence of promotive or protective effects, should be developed and evaluated to identify long-term results. There is much work to be done on examining the ability of PYD constructs to impact ASRH. While there is sufficient evidence for a number of PYD constructs, more longitudinal research is needed. We have argued here that investigation of existing longitudinal datasets may efficiently increase our understanding of the evidence for the promotive and protective effects of understudied constructs or those with mixed evidence. Further, there is a need for the development of standardized measures of PYD constructs and the development and use of measures of positive sexual and reproductive health outcomes. We also recommend that future studies compare the relative strength of the PYD constructs and devote more resources to understanding how these constructs work together to promote ASRH.