Findings from this review of the literature published over the past two decades indicate that the development of acculturation theory and measurement has been impeded by the lack of clear terminology and consistency of measurement. In the majority of studies reviewed, acculturation, however defined in a specific study, was apparently determined to be a risk factor for Latino adolescents' substance use/abuse. A narrow majority of these studies selected preferred use of the English language as the sole measure of acculturation. English-language preference, in combination with other proxy measures of acculturation, was found to be robust predictors of substance use/abuse for Latino adolescents. The studies that used English-language preference in combination with another proxy measure of acculturation, such as length of time in the United States and country of birth, exhibited greater predictive ability for substance use/abuse outcomes for Latino adolescents compared with those that used more complex scales for measuring acculturation. For future research in this area, researchers should develop operational definitions that are consistent. Cultural adaptation for Latino adolescents is apparently multidimensional with possibly competing constructs. Future studies may find it necessary to develop acculturation frameworks that capture values, behaviors, and attitudes that are specific for a given outcome of interest. Some of the values consistently found to be relevant to substance use among Latino adolescents, for example, were family connection and respect for parents, as well as acceptance of culturally prescribed gender roles. Of equal importance in assessing acculturation related to substance use is the assessment of changes related to attitudes toward substance use/abuse as Latino adolescents adapt to mainstream American culture. 2 tables and 65 references