The recent emergence of gambling problems among youth around the world is alarming. For those most vulnerable in our society, children and adolescents, problem gambling presents a serious public health concern. Our current knowledge and understanding of the magnitude of the problem and its considerable impact upon the well-being of youth compels us to respond in a timely and effective manner. A general public health paradigm to gambling, originally articulated by Wynne (1997) and Korn and Shaffer (1999), highlights the importance of such an approach. However, a conceptual model and framework to understand and specifically address youth problem gambling within a public health framework is needed. This article articulates a theoretical framework and model that will help facilitate the development, implementation and evaluation of a comprehensive, multi-level health promotion and prevention strategy for youth problem gambling.