We sought to develop and validate an instrument that can enable providers to identify young women who may be at risk of contraceptive non-adherence. Item response theory based methods were used to evaluate the psychometric properties of the Contraceptive Intent Questionnaire, a 15-item self-administered questionnaire, based on theory and prior qualitative and quantitative research. The questionnaire was administered to 200 women aged 15-24 years who were initiating contraceptives. We assessed item fit to the item response model, internal consistency, internal structure validity, and differential item functioning. All items fit a one-dimensional model. The separation reliability coefficient was 0.73. Participants’ overall scores covered the full range of the scale (0-15), and items appropriately matched the range of participants’ contraceptive intent. Items met the criteria for internal structure validity and most items functioned similarly between groups of women. The Contraceptive Intent Questionnaire appears to be a reliable and valid tool. Future testing is needed to assess predictive ability and clinical utility. The Contraceptive Intent Questionnaire may serve as a valid tool to help providers identify women who may have problems with contraceptive adherence, as well as to pinpoint areas in which counseling may be directed.