In 2019, approximately 21 million children in the United States lived with a parent who misused substances, and over 2 million lived with a parent with a substance use disorder (SUD). While parents with SUD are often invested in preventing intergenerational transmission of substance use, there has been little research devoted to addressing this challenge particularly among parents of adolescents. In this narrative review of existing literature, we take a bioecological perspective that includes individual, interpersonal, and societal factors that offer opportunities for intervention. Specifically, we suggest that there is a need to consider key developmental tasks of adolescence-establishing a sense of autonomy, developing personal identity, and cultivating meaning and purpose-in tandem with effective parenting practices and societal considerations to prevent the intergenerational transmission of substance misuse and use disorders among adolescents when a parent has SUD. We offer specific research recommendations and strategies for leveraging impactful preventative interventions.