Although there has been recent improvement, teen pregnancy continues to be a significant problem, especially in South Carolina where the birth rate to adolescents is higher than the national average. As this is a complex issue, many different interventions including both primary and secondary prevention as well as modification of programs to fit each individual community will be necessary. One initial approach to pregnancy prevention program implementation is a needs assessment of current interventions compared with teen birth rates in a community. This report of a needs assessment for Charleston County revealed a discrepancy between the location of most pregnancy prevention programs (urban areas of the county) and the higher teen birth rates (rural areas of the county,) establishing areas that will be targeted for additional services. Other counties throughout South Carolina may find this approach useful in coordination of community efforts to reduce teen pregnancy.