A growing body of research has demonstrated that boys exposed to a number of risk factors have an increased probability of fathering a child during their teenage years, and that the lives of adolescent fathers are complicated and filled with a multitude of harsh realities. The purpose of this article is to provide a comprehensive review of the research on who becomes a teenage father, the many problems adolescent fathers experience before and after they father a child, how they respond to their duties as fathers, their multifaceted service needs, societal treatment of adolescent fathers, and the difficult challenges associated with recruiting young fathers and retaining them in service programs. Evaluation studies of service programs for adolescent fathers are summarized and critiqued, as are public policies, which have done little to ameliorate the plight of young fathers, and in some cases, have made their already troubled lives more difficult to bear. Future directions for father-friendly clinical practice, public policy, and research pertaining to adolescent fathers are recommended.