In many developed countries, ethnic minority communities bear the brunt of poor sexual health outcomes, with high rates of HIV/AIDS, sexually transmitted infections and their sequelae. Economic disadvantage, social exclusion and racism experienced by these communities all contribute to the observed inequalities. However, culturally prescribed attitudes and behaviours also play an important role. A review of the literature suggests that multifaceted and sustained approaches are needed to improve the sexual health of ethnic minority communities. Chief among these approaches are improving sexually transmitted infection surveillance and research tools; creating collaborative partnerships with communities; targeting high-risk groups and networks; and improving access to, and the utilization of, proven effective interventions.