Pacific youth (15–24 years) experience multiple challenges to realising their sexual and reproductive health and rights (SRHR). Climate-related disasters compound pre-existing social and health inequities, including for youth SRHR. Meaningful youth engagement is crucial to understand their risks and inform inclusive disaster responses. This scoping review aimed to explore if and how both youth SRHR and youth engagement are identified in disaster policies and reported in humanitarian responses. We focus on the 2020 Tropical Cyclone (TC) Harold as a disaster event, providing a real-world example of current approaches to youth SRHR and youth engagement in disaster policies and disaster responses in Fiji, Vanuatu and Tonga. We extract current disaster risk reduction (DRR) policies (Pacific regional framework, national policies and publicly available provincial policies from Fiji, Vanuatu and Tonga), and TC Harold response reports available during the response period from April–September 2020. Using an intersectional policy analysis framework we conduct descriptive and narrative analyses for inclusion and identification of youth SRHR and youth engagement in policies and response reports. Analysis of 9 policies and 28 response reports highlight an existing gap between prioritising youth engagement in policies and the reality of meaningful youth engagement in practice. We highlight a need for regionally consistent disaggregated data to identify youth-specific risks and emphasise the importance of cross-sector collaboration to effectively address youth SRHR. Sociocultural barriers such as misconceptions and stigma, and unilateral decision-making by community power holders underscore the critical importance of applying a rights-based approach to DRR in the Pacific.