While there is widespread support for implementing evidence-based interventions to improve adolescent health, health programs either become out dated and the participants are not engaged or new programs are needed for under-served populations. Innovation receives attention in health care and health systems. However, in health education the focus on innovation surrounds translating programs into practice; there is a lack of information on developing innovative programs which address disparities in teen pregnancy prevention. Given no guidelines exist to support the development of innovative programs in health, this skill is generally lacking and not widely used nor considered especially in content areas like teen pregnancy prevention. This paper discusses the gaps and opportunities for supporting and fostering innovation in adolescent health and teen pregnancy prevention programming.