Background: Oportunidades is a large conditional cash transfer (CCT) program in Mexico. This analysis sought to measure program effects on pregnancy and contraceptive use among young rural women beyond the effects of education. Methods: We used three waves of the ENADID, a population-based survey, to describe trends in outcomes and education among women 15 to 24 years of age. We developed a matched sample from the 2006 survey, used multivariable logistic regression, calculated predicted probabilities, and estimated indirect effects to estimate program impacts. Results: The proportion of rural young women 15-24 reporting any pregnancy stayed flat, while contraceptive use increased steadily (13.2% in 1992 to 18.9% in 2009), but remained low. School attendance by young rural Mexican women increased dramatically. In multivariable analyses, exposure to Oportunidades is not associated with reduced odds of reporting any pregnancy among young women 15-19 (OR = .74; CI = .53, 1.04), and Oportunidades has a small indirect effect on pregnancy via school. Education, marriage, previous pregnancy, and access to health insurance are significantly associated with increased odds of contraceptive use, exposure to Oportunidades is not. Conclusion: We find no evidence that Oportunidades has impacts on adolescent pregnancy and young women’s contraceptive use above and beyond the impacts of education and other covariates. Through its effect on education, Oportunidades indirectly impacts fertility among adolescents. It is important for Mexico to focus on policies that will increase the use of contraception among young rural nulliparous women, regardless of whether they are enrolled in Oportunidades.