Adolescents have the lowest rates of retention in HIV care and ART adherence when compared to other age groups. It is essential for programmers to better understand the adolescent HIV care pathways in sub-Saharan Africa, where public HIV services have been decentralised throughout the region. This evidence and programming brief is the first in a new series focusing on programming for adolescents living with HIV developed in collaboration with Oxford University and the University of Cape Town. It provides a summary of evidence from a systematic review of adolescent care pathways in low- and middle-income countries, a longitudinal community-traced cohort of ART-initiated adolescents in South Africa, and qualitative interviews with HIV care providers. The brief additionally highlights key considerations for strengthening programming and services for adolescents living with HIV.