This article reviews current research findings and presents a conceptual framework for better understanding the relationship between bullying victimization (hereafter referred to as victimization) and substance misuse (hereafter referred to as SM) among adolescents. Although victimization and SM may appear to be separate problems, research suggests an intriguing relationship between the 2. We present a brief, empirical overview of the direct association between victimization and adolescent SM, followed by a proposed conceptual framework that includes co-occurring risk factors for victimization and SM within family, peer, and school and community contexts. Next, we discuss potential mediators linking victimization and SM, such as internalizing problems, traumatic stress, low academic performance, and school truancy and absence. We then identify potential moderating influences of age, gender and sex, social supports, and school connectedness that could amplify or abate the association between victimization and SM. Finally, we discuss practice and policy implications.