Methamphetamine use typically starts in adolescence, and early onset is associated with worse outcomes. Yet, health, functional, and cognitive outcomes associated with methamphetamine use in young people are not well understood. The aim of this study was to comprehensively assess the evidence on health, functional, and cognitive outcomes in young people (10–25 years-old) who use methamphetamine. Sixty-six studies were included. The strongest association observed was with conduct disorder, with young people who use methamphetamine some 13 times more likely to meet conduct disorder criteria than controls. They were also more likely to have justice system involvement and to perpetrate violence against others. Educational problems were consistently associated with youth methamphetamine use. The cognitive domain most reliably implicated was inhibitory control. Key limitations in the literature were identified, including heterogenous measurement of exposure and outcomes, lack of adequate controls, and limited longitudinal evidence. Outcomes identified in the present review – suggesting complex and clinically significant behavioural issues in this population – are informative for the development of future research and targeted treatments. •Youth who use methamphetamine were 13 times more likely to have conduct disorder.•They were more likely to have justice system involvement and perpetrate violence.•Educational problems were consistently associated with youth methamphetamine use.•Inhibitory control was the most reliably implicated cognitive domain.