MOMENTUM identified challenges to youth social accountability related to youth participation, health system responsiveness, and an over-emphasis on short-term project-based accountability compared with sustainable youth-led movement building. Promising practices for youth social accountability emerging from the landscape include capacity building for youth and adults, strengthening relationships between youth and health system actors, leveraging digital connectedness, and targeting accountability efforts at multiple levels of the health system. Through this landscape analysis, we found that youth social accountability implementation is racing ahead of documentation and that there are opportunities to improve youth social accountability practice in order to increase youth leadership and improve the responsiveness of health systems to the needs and rights of youth.