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Cite as: Armstrong R, Zulu J. Applying the social determinants of health lens to the situation of young key populations in Zambia: what can it tell us about what we could do? J Glob Health Rep 2019; 3: e2019008. Background According to census data, Zambia has a predominantly young population with 65% under the age of 25 years. Improving the sexual and reproductive health of young people aged 15–24 years has become a crossing-cutting priority for sustainable development for the country. Certain sub-groups within this population, namely young gay men and other men-having-sex-with-men; young sex workers; young transgender people; and young prisoners – collectively termed key populations – may have poorer sexual and reproductive health than their general population peers. The application of the social determinants of health framework offers a way to understand these inequities in order to more effectively address them.