Introduction: Adolescent Health Services (AHS), also known as Youth-Friendly Health Services (YFHS), aim to meet the unique health needs of individuals aged 10–19. Despite efforts to expand access, utilization remains suboptimal in many settings. This study aimed to determine factors influencing AHS utilization among adolescents in Mbala Township, Northern Zambia. Methods: A descriptive cross-sectional study was conducted among 100 adolescents aged 10–19 years, selected through systematic sampling. Data were collected using a standardized interview schedule and analysed using SPSS version 27. Descriptive statistics summarized participant characteristics. Chi-square tests and binary logistic regression were used to identify factors associated with AHS utilization, with significance set at p < 0.05. Results: While 75% reported having used AHS and 80% had access, only 43% demonstrated good utilization. Knowledge of AHS was high (83%), and 58% held positive attitudes toward their use. Major sources of information included health facilities (46%) and the community (30%). Barriers to utilization included shyness (43%), perceived discrimination by providers (42%), and health worker-related hindrances (73%). Distance to facilities was also a concern, with 50% requiring over 30 minutes to reach care. Utilization was significantly associated with gender (p = 0.031) and education level (p = 0.001). Logistic regression showed that being female (AOR = 1.75, p = 0.031), having secondary education (AOR = 2.90, p = 0.018), and a positive attitude (AOR = 1.84, p = 0.047) were significant predictors of AHS utilization. Conclusion: Despite high awareness and access, effective utilization of AHS in Mbala remains limited, largely influenced by gender, educational attainment, and attitudes. Interventions should focus on promoting youth-friendly services, reducing stigma, and enhancing community and provider engagement to improve adolescent health outcomes.