en تخصصي Special پژوهشي Original article <strong>Background:</strong> Reproductive health (RH) in adolescents and youth, as one of the critical components of population health policies, plays a pivotal role in preventing risky behaviors and achieving a healthy and productive generation for the future society. Thus, this study aimed to explore the challenges of RH in adolescents and youth in Iran.<br> <strong>Methods:</strong> Using a purposeful sampling method with maximum variation, semi-structured in-depth interviews were held with eighteen key informants in the field of RH. A Snowball sampling strategy was deployed to identify the participants. The multi-dimensional PRECEDE-PROCEED model of health promotion was used as a guiding framework for the topic guide. The transcribed interviews were coded and analyzed using thematic analysis.&nbsp;&nbsp;&nbsp;<br> <strong>Results:</strong> Three main themes of decision-making system, lifestyle, as well as social and epidemiological issues, were emerged from the interviews. We also explored six themes, including the knowledge and expertise about RH, policy-making and management system, environmental factors, individual factors, family and social anomalies, and epidemiological status of RH. Furthermore, twenty-five sub-themes were extracted from the main themes, which represented the challenges. Lack of understanding of the issues and absence of a coherent intellectual system that provides a collaboration of different systems in policy-making were fundamental and dominant challenges of RH for adolescents and youth in Iran.<br> <strong>Conclusion:</strong> To meet these challenges, we require an integrated and coherent system of policy-making with a reliance on scanning individual, environmental, social, and epidemiological changes that influence RH. Reproductive health, Sexual health, Adolescents, Youth, Iran 112 126 http://jebhpme.ssu.ac.ir/browse.php?a_code=A-10-179-1&slc_lang=en&sid=1 Mohammad Hossein Mehrolhassani https://orcid.org/0000-0002-2412-9277 No Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Ali Akbar Haghdoost https://orcid.org/0000-0003-4628-4849 No HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Reza Dehnavieh https://orcid.org/0000-0002-6456-1355 No Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Maryam Esmaeili https://orcid.org/0000-0001-5458-6527 No Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Vahid Yazdi-Feyzabadi v_yazdi@kmu.ac.ir https://orcid.org/0000-0002-8009-470X Yes Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran