India has made important gains in improving the sexual and reproductive health of women and young people. These advances include the expansion of the contraceptive method mix under the National Family Planning Programme, efforts to strengthen the contraceptive supply chain, and the 2014 launch of the Rashtriya Kishor Swasthya Karyakram (National Adolescent Health Programme), which prioritizes healthy development during adolescence. Critical gaps in meeting adolescent sexual and reproductive health needs remain. As a result of lack of accurate information, provider bias and other barriers, many adolescents have limited agency to protect and foster their own sexual and reproductive health, and obtaining comprehensive abortion care can be particularly challenging. Difficulties related to obtaining information and services are compounded for adolescents who are marginalized on the basis of their sexuality, gender expression or marital status. Gaps in access to comprehensive sexual and reproductive health care must be addressed for all adolescents, so they can exercise their rights to bodily autonomy and lead healthy lives. The Adding It Up project estimates the need for, impact of and costs associated with increased investment in essential sexual and reproductive health services, including contraceptive care, maternal and newborn health care, and abortion-related care. These estimates demonstrate the immense potential benefits of investments to ensure that young women can decide whether and when to have children and can experience safe pregnancy and delivery. The estimates presented here pertain to adolescent women aged 15–19 in India in 2019.