OBJECTIVE To study cross-country and regional variations and trends in reported teenage pregnancies in the context of legislation and youth sexual and reproductive health (SRH) services in Europe. DESIGN Data were collected on teenage live births and induced abortions, abortion legislation and youth SRH services. SETTING Population-based statistics from the European Union (EU) member states. POPULATION Fifteen- to nineteen-year-old female teenagers. METHODS Detailed statistical information for each member state about teenage live births, induced abortions, abortion legislation and youth SRH services were compiled relying on national and international data sources. MAIN OUTCOME MEASURES The annual reported pregnancies per 1000 women aged 15-19 years. RESULTS Teenage pregnancy rates have declined since 2001, although progress has been uneven across regions and countries. Eastern Europe has a higher average teenage pregnancy rate (41.7/1000) than Northern (30.7/1000), Western (18.2/1000) and Southern Europe (17.6/1000). While data on teenage live births are available across Europe, data on teenage abortions are unavailable or incomplete in more than one-third of EU countries. Reported teenage pregnancy rates are generally lower for countries where parental consent for abortion is not required, youth SRH services are available in all areas and contraceptives are subsidized for all minors, compared with countries where these conditions are not met. CONCLUSIONS The collection of standardized teenage pregnancy statistics is critically needed in the EU. The remarkable variability in teenage pregnancy rates across the EU is likely to be explained, among other factors, by varying access to abortion and youth SRH services.