There is no previous research or documentation of the incidence of pregnancy or pregnancy outcomes in female adolescents after undergoing bariatric surgery.Retrospective chart reviews were conducted for female patients who had bariatric surgery in our adolescent program from 2001-2007. Descriptive and clinical data were abstracted from the medical records, including data from the initial assessment and from follow-up clinic visits pre- and postoperatively.47 adolescents (age <19 years) underwent Roux-en-Y gastric bypass (RYGBP). 7 pregnancies occurred in 6 Caucasian females and resulted in 6 reported healthy term deliveries (1 pending). 6 of the 7 pregnancies were conceived between 10 and 22 months following surgery. In this small cohort of adolescent females, the pregnancy rate was 12.8%.The program pregnancy rate for adolescent females in this cohort was greater than anticipated, compared with national pregnancy rates for age and race-matched females in the USA. Risk factors that may contribute to an increased incidence of adolescent pregnancy in this unique bariatric population are unclear, but may include poor adherence to contraceptive therapy and psychosocial factors. Further research is required to define risk factors, improve adherence to contraceptive therapy, and encourage postponement of pregnancy after surgery.