Objective: To examine young people's requirements and perceptions of sexual health services and education in the context of their experience of sexual relationships and knowledge of sexual health. Design: A questionnaire based cohort study. Setting: Three hundred and sixty Year 11 students (aged 15-16 years) surveyed in three Secondary Schools. Method: The study received ethical approval from The North Wales Central Ethics Committee. School nurses distributed questionnaires in classroom conditions to all students present on the survey day. Results: Eighty-six per cent of the cohort responded. Those young people who reported being sexually active (153, 45 per cent) thought most sexual education topics should be taught around six months earlier than non-sexually active respondents. Of those accessing sexual health services, 90 per cent were happy with the services received, however, only 44 per cent of sexually active males and 76 per cent of sexually active females had sought advice. That clinics had a 'friendly atmosphere and staff easy to talk to' ranked highest and 'only people of your own age using the clinic' ranked lowest on a list of important features for a sexual health clinic. Conclusion: Planners should consult young people and develop services in line with their needs. Sexual health education should be taught earlier in the school curriculum, with flexibility over when some information is accessed. There is little evidence for the assumption upon which much work in this field is based; that most young people prefer a specifically young person's sexual health clinic.