The issue of culture has been scantly addressed in the field of youth residential treatment. However, little research has explored salient aspects of youth culture in residential treatment settings. In addition to the usual definitions of culture (i.e., race, ethnicity, rural/urban, low/ high income), youth often note other unique cultural variations in their existence: substances of choice and availability, language, social interactions, family interactions, preferred music, styles of interactions, and resistance strategies. Issues of "peer contagion" and counter perspectives related to the concept of Positive Peer Culture are discussed. Implications of culture in youth residential treatment are explored and recommendations for culturally grounding programs are made. The author plaees special emphasis on the importance of consulting with youth throughout program formation, implementation and evaluation.