This paper reviews the state of knowledge about relationships between schooling and adolescent reproductive health. With the spread of mass schooling and the growing share of adolescents who attend school, the opportunities for synergies between health and education policies and programs are growing. Data on cross-country variations in health conditions on the one hand, and variations in attendance and attainment patterns and school systems on the other hand, provide a framework for assessing alternative approaches to the promotion of adolescent sexual and reproductive health in different contexts. Disappointing findings from recent school-based reproductive health interventions in poor rural settings raise questions about the widespread applicability of current school-based approaches to promoting sexual and reproductive health.