Parenting during adolescence is often followed by a range of untoward outcomes of young parents and their children. The birth rate and experience of pregnancy and parenting for youth in foster care are, however, little studied. Emerging research suggests greater risk for early pregnancy or parenthood for this population. The research on possible reasons for this elevated risk is considered. This review reports the findings related to prevalence, risk factors, and protective factors for pregnancy and parenting among youth in foster care. Youth report their motivations for parenting and barriers to preventing pregnancy. Child welfare workers and administrators report lack of policy and practice guidance related to pregnancy prevention and reproductive healthcare for youth in foster care.