Adolescent methamphetamine use is a prominent concern for Canadian media and government. Few empirical studies, however, have established the scope of adolescent methamphetamine use or associated outpatient substance abuse treatment utilization. The current study aimed to answer the following questions: (1) What was the overall proportion of primary methamphetamine-related cases seen at youth outpatient substance abuse treatment centres in British Columbia in 2005–2006?; (2) What kind of treatment programming did these treatment centres offer primary methamphetamine users?; and (3) How prepared were these treatment programs to provide services to primary methamphetamine users? We developed a comprehensive list of all sites offering outpatient substance-abuse treatment programs for youth in British Columbia. We asked the Executive Director (or designate) of each facility about the program’s annual caseload, proportion of primary methamphetamine-related cases, treatment approach, and preparedness to provide effective treatment for methamphetamine users. Responses were received from 68 of the 80 centres on our final master list. Approximately 11% (780/6,840) of all cases at the sites were due primarily to methamphetamine use. The proportion of primary methamphetamine-related cases varied widely across sites in B.C., with contacted centres reporting between 0–65% of their caseload in 2005–2006 as primarily methamphetamine-related. Almost all facilities integrated primary-methamphetamine users into treatment-as-usual, and few centres (12%) felt inadequately prepared to offer treatment for methamphetamine users. The current study found a substantial proportion of all cases seen at youth outpatient substance abuse treatment centres in British Columbia in 2005–2006 were primarily due to methamphetamine misuse. While most treatment sites integrated youth methamphetamine users into regular treatment programming and few treatment directors indicated that their programs were inadequately prepared to offer treatment services to methamphetamine-using clients, more evidence is needed to ascertain the most effective treatment strategies for methamphetamine users.