Opioid use disorder (OUD) continues to be a major public health crisis, with the current epidemic being driven by synthetic opioids such as illicitly manufactured fentanyl. While medications exist to treat OUD, only sublingual and subdermal buprenorphine formulations are approved for patients aged 16-17 years. Furthermore, almost all pediatric patients who are diagnosed with OUD do not receive medication as treatment. This case describes the innovative use of buprenorphine extended-release subcutaneous injection in a 17-year-old with OUD who has achieved early remission after four months of treatment. This case supports the use of buprenorphine extended-release in pediatric patients who are at high risk. While buprenorphine extended-release injections are not Food and Drug Administration-approved for pediatric patients, the increase in adolescent overdose deaths and lack of access to treatment in this age group support the need for increased research and treatment options for youth with OUD.Copyright © 2024 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.