Creating structures to include young people's opinions and advice has been recognized as important for high-quality youth programs and services. Recent scholarship has begun to learn that most of these efforts are often symbolic rather than substantive. While continually advocated for, the practice is not widespread or well done. Using data from a statewide study of youth advisory structures and a case study of one advisory structure used within a municipal parks and recreation center, this article describes what both of these teach about creating substantive, meaningful, and useful youth advisory structure for program and organization development.