Youth unemployment rates in the United Kingdom are almost triple that of adults (11.3% vs. 4%), particularly impacting the employability of young people with complex needs, of whom 61.8% are unemployed. Interventions facilitating transition into work can operate at individual, community and government levels. The main objectives of this review were to explore current practices, identify factors affecting and strategies used to improve employability, and classify strategies at multi-levels. Findings suggest that collaborative strategies covering training, work practices, therapeutic support and creating appropriate work environments, with active involvement of young people, are key in supporting young people with complex needs into employment. Classification of factors indicated four categories: skills-based approaches, job/work experience accessing approaches, therapeutic interventions, and supportive working environments.