This paper examines the intersecting issues of mental health, poverty, and systemic inequality affecting incarcerated girls aged 14 to 17 in North Macedonia and Italy. Although constituting a small proportion of the juvenile justice population—only 2.6% in Italy and even fewer in North Macedonia—these girls face disproportionately severe vulnerabilities. The paper analyzes the socio-economic and psychological profiles of incarcerated girls, highlighting the overrepresentation of marginalized groups such as foreign-born minors in Italy and Romani youth in North Macedonia. It explores how poverty, lack of education, and absence of family or community support contribute to incarceration and complicate reintegration post-release. The study further investigates institutional shortcomings, including inadequate mental health services, the absence of girl-specific correctional infrastructure, and limited access to gen der-sensitive rehabilitation programs. Drawing on national reports, EU legal frameworks, and recent legal and policy reforms, the paper calls for a rights-based, gender-responsive approach that includes educational continuity, mental health support, and non-custodial alternatives. The analysis demonstrates that a shift from punitive to rehabilitative, community-based models is essential to protect and empower one of the most vulnerable groups in Europe’s justice systems.