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The growing prominence of social media use among teenagers has prompted researchers in psychology and communication science to consider connections between social media activities and youths’ development and well-being. This systematic, narrative review evaluated associations between social media use and the internalizing symptoms of depression, anxiety, and loneliness among 12–18-year-olds, based on 68 qualifying empirical studies conducted between 2000 and 2017. For each symptom, analyses assessed the theoretical underpinnings of studies; the strength, direction, and consistency of associations with social media use; and factors mediating or moderating these associations. Investigators often reported positive associations between social media use and internalizing symptoms, but more nuanced studies pointed to individual, contextual, or media-based factors qualifying these direct effects …