The article reviews the risk prevention paradigm and contemporary responses to youth posing a risk and, to a lesser extent, youth at risk. The underpinning notions of prudentialism and the rational actor are critiqued and limits to this policy approach are explored. The article will review the limitations of this position and draw on recent empirical evidence on the decision making of youth to illustrate that prudentialism is often not that clear cut. A greater understanding of decision making is advocated and the implications of starting with how young people think about risk decisions are reviewed.