In this study I reviewed the Canadian and international published literature examining youth mental health courts to provide an overview of their processes, mechanisms of change, and outcomes. A systematized literature review was conducted using the PRISMA-ScR checklist as a guideline following a search of PsychINFO, ERIC, ASSIA, MEDLINE, Sociological Abstracts, Social Services Abstracts, Criminal Justice Abstracts with Full Text, and Child and Adolescent Studies databases. Inclusion criteria stipulated that studies be original research, and examine at least one aspect of the courts’ operations or outcomes. Twenty articles satisfied inclusion criteria. Results showed considerable similarities among intake, referral and case monitoring procedures across courts, and recidivism outcomes. Youth reported courts to be collaborative and supportive, with stakeholders reporting reduced case processing times, improved access to treatment services and reduced recidivism. I highlight findings on operations and outcomes of youth mental health courts that have important implications for policy and practice.