Pregnancy during adolescence is a worldwide public health concern. In developing countries, 14 million adolescents give birth each year, which accounts for 90% of all worldwide pregnancies. The proportion of adolescent women aged 10-19 whom have been pregnant in Mitú, Colombia is of approximately 25%, in comparison to 19.5% at the national level. This report aims to review the effectiveness and identifying best practice of adolescent pregnancy interventions in low and middle income countries and use formative research to make specific recommendations for policy and practice to prevent adolescent pregnancy in Mitú, Colombia. EMBASE, Medline, CINHAL, Cochrane library, GLOBAL HEALTH, ADOLEC, Popline, LILACS and REPRODUCTIVE HEALTH LIBRARY were searched to identify studies examining adolescent pregnancy prevention interventions in developing countries. GOOGLE was searched to identify grey literature. Five semi-structured interviews were also conducted with key service providers in the field of Adolescent Sexual and Reproductive Health in Mitú to explore the needs of the region in regards to adolescent pregnancy prevention and the barriers and facilitators for programme implementation. The literature review found that adolescent pregnancy prevention interventions in developing countries had a positive impact on the knowledge of pregnancy prevention and may contribute to the delay of sexual initiation. However, impact on the use of contraceptive methods and reduction of adolescent pregnancy inconclusive. Interviews revealed key societal, familial and individual factors that were viewed to be linked to adolescent pregnancy in Mitú. Relationships between military personnel and young women appeared to be an important factor in high teenage pregnancy rates. Barriers for the adequate implementation and continuation of programmes included lack of political commitment, lack of financial, human and material resources and lack of inter-institutional collaboration, the high rate of staff turnover and the lack of monitoring programmes. Only few facilitators were mentioned that consisted mainly in the willing of both adolescent and military to collaborate in the implementation of adolescent pregnancy prevention interventions. In conclusion, evidence suggests that adolescent pregnancy prevention strategies are effective in increasing knowledge of pregnancy and might delay sexual initiation in low and middle-income countries. Features of effective programmes were identified and discussed and are important in designing and developing new strategies. However, cultural, environmental and social barriers need to be addressed through political commitment and inter-institutional collaboration in order to develop effective interventions for pregnancy prevention in Mitú.