Introduction <p>Youth involved with the child welfare system face notably poorer sexual and reproductive health (SRH) outcomes compared to their peers. Several SRH programs have been developed to address these health disparities, yet there is limited consolidated research examining these programs. The purpose of this systematic review was to synthesize quantitative and qualitative research on programs and conceptual models that could improve the SRH of child welfare system-involved youth.</p> Methods <p>We conducted a systematic search of published articles using <i>PsychINFO</i>, <i>Medline</i>, <i>CINAHL</i>, and <i>Communication Source</i> through March 1, 2023, as well as a gray literature search. Study inclusion criteria included: (1) a program or conceptual model designed to promote the SRH of child welfare system-involved youth; (2) a U.S.-based sample; and (3) available in English.</p> Results <p>We located 29 articles; 24 assessed programs (20 targeting youth and 4 targeting adults), and 5 presented conceptual models. Most youth programs focused on reducing pregnancies or HIV/STIs. Four programs for youth evaluated through RCTs were efficacious in improving SRH outcomes over time. Four programs for foster caregivers and social workers emphasized developing skills for communicating with youth about SRH topics.</p> Conclusions <p>This review sheds light on the current effectiveness of existing SRH programs for youth and adults, as well as gaps in available programs and research.</p> Policy Implications <p>Increased investment is needed in youth programs that emphasize the positive dimensions of sexuality and relationships, alongside adult programs designed to enhance skills for supporting youth SRH. Additionally, funders should prioritize rigorous evaluations of these SRH initiatives to ensure their effectiveness and sustainability.</p>