This report describes hospitalizations related to substance use among youth aged 10 to 24 in Canada between 2018 and 2024. It examines trends in hospitalizations by age, sex, province or territory, income level, urban or rural/remote location and substance. The national rate of substance-related hospitalizations among youth aged 10-24 declined by 22% between 2018-19 and 2023-24. Cannabis and alcohol were the leading causes of substance-related hospitalizations across most provinces and territories, sexes, and age groups. Over 60% of youth hospitalizations involved a co-occurring mental health condition.