Globally, young sex workers who use drugs (YSWUD) are at the intersection of laws and policies that criminalize and stigmatize both drug use and sex work which, when compounded by age, leads to increased state targeting and surveillance. Such punitive responses create significant barriers for YSWUD in accessing health, social, and harm reduction services, while also increasing exposure to structural and everyday violence (e.g., overdose risk, increased workplace violence, police targeting, etc.). In order to better highlight the global realities and priorities of YSWUD, this commentary brings together YSWUD from across the world to speak to their unique experiences and expertise with the aim of providing guidance around how service providers and policy makers can move beyond the logics of criminalization to best engage with YSWUD.