Although increasing numbers of youth are seeking help to reduce or abstain from marijuana use, little research has investigated the contextual facilitators and barriers to doing so among urban youth utilizing primary care. We qualitatively investigated contextual facilitators and barriers to marijuana reduction/abstinence in an ethnically diverse primary care sample of youth who frequently use marijuana. We interviewed thirteen (Black/African American (69%), Hispanic (8%), White (8%) unknown (15%)) youth (eight females) aged 15-23 years (mean = 19.46). Data were analyzed using Interpretative Phenomenological Analysis. Participants' motivations for marijuana reduction/abstinence included physical health, cognitive functioning, future goals, and money. Barriers to reduction/abstinence were psychological (e.g. stress and boredom), and sociocontextual (e.g. family, friends, and the neighborhood). Our findings suggest using a two-pronged approach to support marijuana reduction/abstinence in youth: individual-level interventions to address psychological factors that impede behavior change, and broader community-based interventions to address sociocontextual factors.