Residing in high-risk urban neighborhoods has a significant impact on the optimal psychosocial development of adolescent African American males. Living in these environments often increases exposure to economic distress and attendance at under-resourced schools, which may diminish opportunities for successful life outcomes. This qualitative systematic review examines how continuous exposure to high-risk neighborhoods affects the mental health of adolescent African American males. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, twelve articles were systematically reviewed. Results suggest that African American male adolescents continuously exposed to negative characteristics within their neighborhoods display higher rates of depression, and other symptoms of psychological distress. However, further research is needed to identify the specific mechanisms in high-risk neighborhoods that are most salient in increasing their negative mental health symptoms.