Media literacy education to promote health among youth involves them in a critical examination of media messages that promote risky behaviors and influence their perceptions and practices. Research on its effectiveness is in its infancy. Studies to date have been conducted with more or less rigor and achieved differing results, leaving many questions about effectiveness unanswered. To elucidate some of these questions, we conducted a systematic review of selected health-promoting media literacy education evaluation/research studies, guided by the following research question: What are the context and process elements of an effective health-promoting media literacy education intervention? Based on extensive analysis of 28 interventions, our findings provide a detailed picture of a small, 16- to 17-year (1990 to July 2006) body of important research, including citation information, health issue, target population/N/age, research design, intervention length and setting, concepts/skills taught, who delivered the intervention and ratings of effectiveness. The review provides a framework for organizing research about media literacy education which suggests that researchers should be more explicit about the media literacy core concepts/skills they are including in their interventions, and should more carefully address who delivered the intervention with what fidelity, in what setting, for how long and utilizing what pedagogical approach.