Teenage pregnancies are worldwide a major problem, though large regional differences do occur. Ecuador has an incidence of 6,6%, which is better than most other countries in this part of the world. Recently however, an increase has been observed. Socio-economic and cultural factors play a role, as well as a lack of sexual education, young age at sexual debut and a failing family structure. The neonatal and obstetric outcome of teenage pregnancies remains subject to controversy, yet a large scale study in South America recorded an increased risk for mother and child in teenage pregnancies. These pregnancies remain a major health problem in Ecuador, despite the effort of the government and various professional organizations. Strategies to reduce the problem should focus on the lower socioeconomic class and on prevention through sexual education.