Young people are entitled to be involved in decisions about their health care, yet many are not engaged in any meaningful way. This article outlines the approach taken by Newcastle Upon Tyne Hospitals NHS Foundation Trust and partners to implement quality criteria for young people-friendly health services. It describes the opportunities and challenges of actively involving young people in their care. Several approaches that have been applied in diverse healthcare settings are illustrated. Recommendations on how to engage young people are provided from the authors’ experiences.