Blood flow restriction training (BFRT) involves applying external compression to the limbs to restrict venous blood return during low-intensity exercise, thereby promoting improvements in muscle mass and strength. Originally developed decades ago, BFRT has gained renewed interest in recent years, with applications spanning rehabilitation medicine, aerospace, and general fitness. However, its use in adolescents remains limited and under-researched. This narrative review aims to summarize the current understanding of the effects, mechanisms, and practical applications of BFRT in adolescents, with a focus on muscle health, physical performance, and training safety. A comprehensive review of recent literature was conducted, focusing on BFRT-related physiological mechanisms, including metabolic stress, anabolic hormone responses, muscle fiber recruitment, protein synthesis regulation, myostatin suppression, and cell swelling. Relevant studies on adolescent populations were analyzed to evaluate the efficacy and safety of BFRT in this age group. BFRT appears to promote muscle hypertrophy, strength, endurance, and neuromuscular adaptations in adolescents, with reduced injury risk compared to high-load training. Individualized arterial occlusion pressure settings enhance both the safety and effectiveness of BFRT. Applications span general fitness, athletic performance enhancement, and injury rehabilitation. BFRT offers a promising, low-risk alternative to traditional resistance training for adolescents, supporting safe and effective physical development. Its integration into youth fitness and rehabilitation programs by educators, healthcare providers, and sports organizations may offer substantial benefits for adolescent health and performance.