Depression has been increasing rapidly and is prevalent among youth. Inadequate mental health service utilization for youth and relevant racial/ethnic disparities are a growing concern. The current study used a nationally representative database to examine racial/ethnic disparities in youth depression prevalence, mental health services utilization, and psychotropic medication receipt. The sequential examination shows that depressed minority youth (22%-30%) were not only much less likely to use specialty mental health services than depressed Caucasian and multiracial youth (40%-43%, p < 0.001), they were also much less likely to receive psychotropic medications (22%-30%) than their Caucasian and multiracial counterparts (38%-44%, p = 0.048 to <0.001) when using specialty mental health services. The findings reveal possibly two levels of racial/ethnic disparities at the decision points of accessing specialty mental health services and subsequent treatment methods choice. Implications for mental health policies and practices are also discussed.