BACKGROUND: Despite the increasing attention paid to adolescents with substance use disorders (SUD), the financial investment does not appear to align with the escalating demand for its prevention and treatment services. This study aims to provide comprehensive and up-to-date estimates of the burden of SUD among adolescents globally, regionally, and nationally over the last 32 years. METHODS: Utilizing data from the Global Burden of Disease, Injuries, and Risk Factors Study 2021, we concentrated on adolescents aged 10 to 24 years with SUD. We conducted a Bayesian age-period-cohort analysis and Nordpred model that encompasses age-standardized prevalence rates (ASPR), age-standardized incidence rates (ASIR), disability-adjusted life years (DALYs) rates, and estimated annual percentage change (EAPC) across various demographic factors, including regions, age groups, gender, and socio-demographic index (SDI), covering the period from 1990 to 2021. RESULTS: From 1990 to 2021, there was a significant decrease in the burden of adolescent SUD (EAPC = -1.17, 95%CI: -1.29 to -1.05). However, tremendously increasing trends of rate of DALYs were observed in high SDI regions (EAPC = 1.21, 95%CI: 1.11 to 1.32). Substantially increasing trend of burden attributable to adolescent SUD was detected in the United States of America (EAPC = 1.78, 95%CI: 1.64 to 1.92). Mongolia exhibited significantly increasing trend of ASPR (EAPC = 1.33, 95%CI: 1.10 to 1.56) and ASIR (EAPC = 1.21, 95%CI: 1.02 to 1.39). By 2030, the age-standardized DALYs rate of global adolescent SUD will decline from 88.49 to 79.27 per 100,000 individuals. CONCLUSIONS: The burden of adolescent SUD shows diversity among SDI regions and countries. It ought to set a series of strict policies for adolescent substance control and precise financial management in prevention programs.