This research article discusses data from drug treatment facilities, drug seizures, and drug arrests that suggest rapidly increasing methamphetamine use by adolescents in Thailand. A cross-sectional survey of 1,725 students, 15- to 21-years-old in 6 grades, attending one of three vocational schools, was conducted using anonymous audio-computer-assisted self-interview and urine specimen analysis. In order to analyze risk factors associated with reported methamphetamine use, univariate and multivariate logistic regression analyses were performed to calculate odds ratios, adjusted odds ratios, and 95 percent confidence intervals. All statistical analyses were carried out using SSPS for Windows version 10.05. Tables are included showing reasons for methamphetamine use, results of univariate analysis, and results of multivariate logistic regression analysis, and overall multivariate analysis. It was found that 350 males and 150 females reported ever using methamphetamine, with 128 males and 49 females having positive urine tests showing recent use. Twenty seven of those students denied ever having used methamphetamine. In multivariate analysis, methamphetamine use was highly correlated with the use of other substances, sexual activity, peer pressure, positive attitudes toward methamphetamine, and absence of a family confidant. Primary prevention, safer use and treatment and recovery programs are urgently recommended for implementation to contain this serious threat to the youth in Thailand.