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Sweden has relatively high rates of adolescent pregnancy despite comprehensive sexual education for adolescents, and Thai adolescent immigrants are particularly at risk. The aim of this study was to explore perceptions of adolescent pregnancy among Thai adolescents living in Sweden. A qualitative descriptive study was conducted in 2011, using a purposive sampling strategy to recruit male and female Thai adolescents (age 15-19). Eligibility criteria included: Thai-speaking; single; residing in Sweden >= 6 months but <5 years. Four focus groups were undertaken (N = 18). Each group was transcribed verbatim, and analyzed using a manifest content analysis approach. Five different categories emerged in analysis: risk factors, preventative factors, negative consequences, factors for considering and ending pregnancy, and strategies for prevention. Participants perceived adolescent pregnancy as having negative consequences, including social perceptions within Thai immigrant communities of pregnant adolescents as "a bad person." Participants identified family readiness, economic factors, maturity, and cultural influences, in particular related to Buddhist beliefs, as key factors in Thai adolescents' decision-making about abortion when facing an unintended pregnancy. Although Thai adolescents residing in Sweden live in a sexually open society with comprehensive sexual education and youth services, they endorsed contraceptive myths and perceived adolescent sexual activity and pregnancy as stigmatized among their family and peers. Attention to family, peers, and contraceptive knowledge variables may be particularly important in sexual health interventions for this population group.