Hookah smoking is highly prevalent and has been rising in popularity among young people worldwide. Yet, no recent and comprehensive reviews have been published to assess the prevalence and identify the main predictors of hookah use. We have thus carried out a comprehensive scoping review to consolidate and review the existing evidence for the prevalence and main determinants of hookah smoking among youth. A comprehensive literature search was thus conducted utilizing various databases including ScienceDirect, Scopus, Embase, and MEDLINE to identify relevant studies. To be incorporated in this review, studies had to include individuals below the age of 25, measure the prevalence of hookah smoking, or examine the determinants of hookah smoking. The review showed that hookah is mostly prevalent among youth from the Middle Eastern region, USA, South Asia, and various European countries. It also identified the main determinants of hookah smoking, which include age, the male gender, socioeconomic status, geographic region, other forms of substance use, knowledge, beliefs, and attitudes toward hookah smoking, sensation seeking, having friends and/or family members who smoke hookah, social acceptability, intention, accessibility, and lack of enforcement of prohibiting laws. The main determinants of hookah use include having friends and/or family members who smoke hookah, social acceptability, attitude, accessibility, and lack of enforcement of prohibiting laws. Public health authorities, educators, and other stakeholders should implement educational interventions to enhance the knowledge level on hookah smoking's harm and addiction and should target not only the individuals but also the family and the social environment.