• The principle of consistently following a strengths-based approach is core to all facets of youth development work but there are varied conceptualisations of what this means across different research disciplines. This literature synthesis explores the contemporary debates and tensions surrounding different conceptualisations of what is and what leads to positive youth development and wellbeing from three popular international perspectives: adolescent health, resilience and Positive Youth Development (PYD). It also explores how these ideas play out in Aotearoa New Zealand-based youth research and highlights potential implications for youth policy, programming and practice.• Consultation with Aotearoa New Zealand-based researchers and research-engaged educators and practitioners of youth development facilitated identification of influential international theorists, theories, models, frameworks and bodies of empirical work on positive youth development and wellbeing to help delimit the scope of the review. We sourced recent published works by the recommended scholars and prioritised reviews and commentaries that summarised each perspective. We identified points of convergence as well as seven key tensions that captured some of their differentiating features. These include the degree to which each perspective: frames youth development from a strengths vs. a problem-focus; focuses on high risk vs. all youth; emphasises individual vs. contextual factors; accentuates parsimonious and universal vs. complex and contextually-specific principles of human development; privileges quantitative, positivist research vs. methodological pluralism; considers culture; and links to empirically-supported theory. We then assessed the degree to which these tensions were present in Aotearoa New Zealand-based literature on adolescent health, resilience and PYD.• Internationally, the adolescent health perspective is characterised by an aim to increase understanding of the risk and protective factors that influence youth development and wellbeing so this knowledge can be used to reduce rates of adolescent morbidity and mortality. In this sense, the field’s orientation is problem-focused. Risk and protective factors are generally identified through large scale, population-based, quantitative surveys and statistical models that are not typically linked to theory but demonstrate how variables combine to predict health outcomes.• The adolescent health perspective highlights the unique and challenging nature of adolescence, and how global forces have changed the world to such a degree that the adolescent experience is fundamentally different today compared to half a century ago. Today, health risks are strongly linked to behaviour. From this perspective, positive youth development boils down to healthy behaviours, facilitated by positive environmental factors, which results in continual good health. The solution from this perspective is translating prevention science into evidence-based policies and programmes, scaling these initiatives globally and then testing for cross-cultural differences. In the case of intervention research, evidence of effectiveness from randomised controlled trials and robust quasi-experimental designs are privileged.• There is agreement within the adolescent health perspective that person-environment interactions drive developmental and wellbeing outcomes and we gain little from an individualised focus alone. Therefore, adolescent health frameworks emphasise the importance of targeting the structural or macro-level determinants (eg policies) of health that generate social stratifications and inequity within society. Nevertheless, the focus …