As national social safety nets are expanding in Africa and globally, evidence on the impact of programs on youth transitions can help guide future investment and program design decisions. This paper examines the effects of Malawi’s flagship cash transfer program on safe transitions to adulthood among youth living in households experiencing ultra-poverty. The evaluation was a cluster-randomized control trial implemented over three years using panel data on youth aged 13 to 19 at baseline. Household-receipt of bi-monthly transfers led to improvements in four out of six outcome domains: 1) education, 2) physical health, 3) mental health and emotional wellbeing, and 4) sexual and reproductive health. There were limited or no impacts on outcomes related to HIV risk and time use. Results imply that similar programs in the region may also facilitate safe youth transitions. Nonetheless, more intentional designs may have promise for more holistic impacts, and further evidence is needed on longer-term effects.