This systematic review and meta-analysis synthesized findings from studies examining culturally sensitive substance use treatment for racial/ethnic minority youth. An extensive literature search located eight eligible studies using experimental or quasi-experimental designs. The meta-analysis quantitatively synthesized findings comparing seven culturally sensitive treatment conditions to seven alternative conditions on samples composed of at least 90% racial/ethnic minority youth. The results from the meta-analysis indicated that culturally sensitive treatments were associated with significantly larger reductions in post-treatment substance use levels relative to their comparison conditions (g = 0.37, 95% CI [0.12, 0.62], k = 7, total number participants = 723). The average time between pretest and posttest was 21 weeks (SD = 11.79). There was a statistically significant amount of heterogeneity across the seven studies (Q = 26.5, p = 0.00, tau2 = 0.08, I2 = 77.4%). Differential effects were not statistically significant when contrasts were active generic counterparts of treatment conditions (direct 'bona fide' comparisons; g = -0.08, 95% CI [-0.51, 0.35]) and 'treatment as usual' conditions (g = 0.39, 95% CI [-0.14, 0.91]). Strong conclusions from the review were hindered by the small number of available studies for synthesis, variability in comparison conditions across studies, and lack of diversity in the adolescent clients served in the studies. Nonetheless, this review suggests that culturally sensitive treatments offer promise as an effective way to address substance use among racial/ethnic minority youth.