OBJECTIVES: The aim of this study was to analyze the efficacy and safety of long-acting reversible contraceptive methods (LARC) compared to conventional contraceptive methods in adolescents. METHODS: We performed, a systematic search in Medline, Embase, Lilacs and the Cochrane Database from inception to May 2016, for observational studies and randomised controlled trials comparing the use of LARC versus non-LARC in adolescents. Two reviewers independently selected studies, assessed quality, and extracted data. Discrepancies were resolved through consensus. The outcomes were adherence, pregnancy rate, adverse events, abortion rates, and adolescent’s contraception choice. We used the RevMan 5.0 to combine results across studies. We derived risk ratios (RRs) and mean differences with 95% CIs using a random-effects meta-analytic model. RESULTS: Nine relevant studies were included. LARC’s 12 months adherence is better than non-LARC (RR 1.38 [95% CI 1.01 – 1.87]); analyzing only more recent studies, those since 1999, an even better 12 months adherence (RR 1.53 [95% CI 1.05 – 2.23]) was observed. There was no difference between LARC and non-LARC concerning the pregnancy rate (RR 0.46 [95% CI 0.09 – 2.52]). Also, there was no difference between the methods in relation to adverse events (RR 0.78 [95% CI 0.59 – 1.03]), abortion rates (RR 1.88 [95% CI 0.07 – 47.60]). Adolescent’s contraception choice favored non-LARC (RR 0.63 [95% CI 0.33 – 1.19]). CONCLUSIONS: LARC presents better adherence with no difference in relation to the pregnancy and abortion rates. Also, there is no difference concerning adverse events between LARC and non-LARC. Notwithstanding, non-LARC is still preferred by the adolescents, although without statistical significance. We conclude that LARC has potential benefits on preventing unplanned pregnancy among adolescents. However, it is noteworthy that most of the included studies are from the 1970’s and the absence of more recent studies comparing new available technologies may impact our results.