The health and other risks associated with early pregnancy and sexual activity raise urgent need for appropriate interventions and programs to address adolescent reproductive behaviors. It is important to understand the circumstances surrounding, and factors associated with unintended pregnancies among young people, the challenges that limit their ability to protect their sexual and reproductive health, and how they deal with the outcomes of unintended pregnancy. While previous research has highlighted the high vulnerability of young slum residents to unintended pregnancies and associated poor health and socioeconomic outcomes, their strategies and practices for managing the consequences of unintended pregnancy have received little attention. The current formative study addresses this evidence gap and focuses on the management of unintended pregnancy among adolescents living in resource poor settings. Our study aimed to answer the following questions: What are the unintended pregnancy-related experiences of adolescents in urban poor communities in Kenya? Secondly, how do these adolescents manage the consequences of unintended pregnancy? The experience of an unintended pregnancy leads to two primary responses; carrying the pregnancy to term or termination of the pregnancy. The goal of the current formative study is to understand how young people make decisions and deal with the consequences of an unintended pregnancy. Study findings are expected to inform the design and delivery of SRH intervention programs to meet the unique needs of adolescents living in resource poor urban settings.