The transition from adolescence to adulthood for many urban black youth today contains a number of formidable barriers and often results in a variety of adverse developmental and behavioral outcomes. Nurses and other health providers have an obligation to answer the urgent need for improvements in the health status of black adolescents. This paper reviews the current psychosocial functioning of black youth while emphasizing the disadvantaged social contexts in which most live, which place them at a higher risk for a variety of negative outcomes. Data concerning mental and social health indicators for black adolescents suggest (a) a negative mental health trajectory with high rates of depression, psychiatric hospitalization rates, and suicides, and (b) a poor social health status with alarming school dropout and juvenile delinquency rates, and chronic violence exposure, substance use, and teen pregnancy. An application of the stress-coping framework to black adolescents is suggested as a way to conceptualize the relationship between stress factors and their influence on development. Because this framework places much emphasis on environmental factors as causes for psychological distress, it provides a means to account for the differential incidence of mental and social illnesses among black adolescents. Nursing interventions related to stress and coping among black adolescents may serve to increase well-being and actualize health promotion. However, research efforts are needed to discover which strategies are used by black youth to cope with the stressful experiences faced in their daily lives. Findings could enhance the design, planning, and implementation of prevention and educational programs, making them more consistent with the unique needs of black adolescents.