This paper critically reviews 48 studies which examine the use of the Rorschach in adolescent populations. Several methodological concerns present in this literature are addressed, including (a) small sample sizes, (b) wide age ranges within the samples, (c) limited generalizability due to narrowly defined constructs and examination of highly specific groups, (d) frequent reliance on recorded diagnosis to determine group membership, and (e) limited comparability across studies due to the use of highly variable scoring and interpretation systems. In spite of these difficulties, there is some evidence that the Rorschach does provide useful and valid measures of reality testing, cognitive complexity, and disordered/psychotic thinking; general psychological distress; disturbance in object relations; and depression in specific adolescent groups. Clinical implications and directions for future research are discussed.