Background Childhood and adolescence are critical stages for a healthy life. To support countries in promoting health and development and improving health care for this age group, the WHO Regional Office for Europe developed the Eu-ropean strategy for child and adolescent health 2015-2020, which was adopt-ed by all countries. This paper reports progress in the strategy's implementation until 2020.Methods A survey was sent to all ministries of health of the 53 Member States of the WHO European Region. Responses were received from 45 Member States. Results are presented in this paper. Results The European Region made overall progress in recent years, but increas-ing levels of overweight and obesity among children, adolescent mental health and low breastfeeding rates are recognized as key national challenges. Although forty-one countries adopted a national child and adolescent health strategy, only eight countries involve children in their review, development and implementa-tion stages. Two-thirds of countries have a strategy for health-promoting schools and a school curriculum for health education. One-third of countries do not have legislation against marketing of unhealthy foods and beverages to children. Most countries reported routine assessment for developmental difficulties in children, but less than a quarter collected and reported data on children who are develop-mentally on track. There are major gaps in data collection for migrant children. Hospitalization rates for young children vary five-fold across the region, indicat-ing over-hospitalization and access problems in some countries. Only ten coun-tries allow minors access to health care without parental consent based on their maturity and only eleven countries allow school nurses to dispense contracep-tives to adolescents without a doctor's prescription.Conclusions This paper shows the progress in child and adolescent health made by countries in Europe until 2020 and key areas where additional work is need-ed to move the 2030 agenda forward. The survey was undertaken before the COVID-19 pandemic and the war in Ukraine. Both will likely exacerbate many of the observed problems and potentially reverse some gains reported. A renewed commitment is needed.