Services for juveniles who exhibit substance abuse disorders, mental health disorders, or co-occurring disorders are rapidly improving across the country. This article reviews what is known about innovative, effective prevention a nd treatment strategies for juveniles with substance abuse issues. It also reviews effective treatment options for juveniles exhibiting signs of mental illness or co-occurring disorders. Juvenile drug courts and mental health courts are examples of such innovative programming. Our extensive review of literature also reveals other treatment models and programming that are effective for substance abuse treatment, including diversion to community treatment and Functional Family Therapy. And in addition to mental health courts, we find that Multi-systemic Therapy, system of care, and special needs diversionary programming are promising approaches to treating juveniles with mental illness. Finally, we conclude with a call for further research and evaluation to determine the effectiveness of treatment for juveniles with co-occurring disorders.