Adolescent girls in Nigeria experience a disproportionately high burden of sexual and reproductive health disparities that affect their well-being. Yet, little is known about adolescent girls' own unique perspectives of the sexual and reproductive health challenges they face, and possible solutions to these challenges. To explore top sexual and reproductive health concerns of female adolescents in Nigeria and their perceptions regarding potential solutions to these issues. Eighty adolescent girls attending two public secondary schools in Lagos, Nigeria completed individual free-listing interviews. Items assessed their perceptions of the most important sexual and reproductive health issues and potential solutions to these issues at the individual and societal level. Data were analyzed using Anthropac 4.98 to sort the lists by item frequency as well as to determine Smith's salience index (S). The top five sexual and reproductive health concerns identified by participants were human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), followed by menstrual pain, vaginal infections, sexual abuse and teenage pregnancy. Adolescent girls stated that youth empowerment programs that provide access to skills-building opportunities and mentors was one potential strategy for addressing their sexual and reproductive health priorities. Other solutions identified were access to medical checkups, general health talks focused on their sexual and reproductive health concerns as well as access to health facilities and opportunities to build self-efficacy skills. Adolescent girls in Nigeria need to be engaged in becoming powerful agents in improving their own sexual and reproductive health, and in crafting solutions that may be effective in enabling them to achieve their full potential and rights to health and well-being. The findings will be used to develop an intervention targeting the sexual and reproductive health priorities of adolescent girls in Lagos, Nigeria.