Advances in the development of highly sensitive tests for Chlamydia trachomatis offer new options for screening and testing in adolescents. The availability of nucleic acid amplification technologies may make noninvasive urine testing available for young men and for young women when a gynecologic examination is not otherwise required. Accurate detection of asymptomatic chlamydial disease in a timely, cost-effective, and noninvasive manner as well as development of effective partner treatment strategies remain important challenges. This review provides a clinical update on office-based testing for C. trachomatis, management, and treatment options for the adolescent and young adult population.