Purpose: This study aims to describe how firearm homicides among adolescents change over a five-year period. Methods: This serial cross-sectional analysis uses surveillance data collected by the Illinois Violent Death Reporting System. Decedent selection criteria included the following: manner of death was homicide, weapon type was firearm, age was 15-19 years, and location of fatal injury was Chicago. Data collected between 2013 and 2017 were used. Multiyear rates per 100,000 and rate ratios were calculated by sex and race/ethnicity. Joinpoint regression analysis and chi-squared tests of linear-by-linear association were used to identify trends over time (by year, month, and weekday). Geographic Information System mapping was used to visualize data. Results: There were 509 victims of firearm homicide aged 15-19 years in Chicago between 2013 and 2017. Overall rates were significantly higher in 2016 than in all other years. Victims were disproportionately black males, comprising 75.6% of total adolescent homicides and increasing by 87.8% across the five years. The rate ratio for black males versus all other adolescents peaked in 2015 at 19.4 (95% confidence interval, 10.9-34.6). For black males, the percentage of fatal injuries occurring on Saturdays and Sundays decreased significantly (p = .048). Among all victims, firearm deaths became less dispersed throughout Chicago, and "hot spots" shifted from the South Side to the West Side. Conclusions: Adolescent firearm homicides are increasing over time, however, in Chicago, a more accurate narrative would portray their consolidation with regard to spatial and racial/ethnic variances across the city. Such analyses define Chicago's firearm homicide epidemic and can shape targeted and effective interventions. (C) 2020 Society for Adolescent Health and Medicine. All rights reserved.