The goals of this study were to examine the relationship between age at first drink and age at first sex among an emergency department sample of Black, Hispanic, and White adolescents (N = 1,1110) and to assess two sexual behavior-related consequences of underage drinking. The authors used multivariable linear regression to analyze data from a self-reported survey. Age at first sex decreased linearly with decreasing age at first drink (p < .001) for all adolescents in the sample. In analyses stratified by race, significant positive trends between age at first drink and age at first sex were observed for all race and ethnic subgroups, although the relationship between age at first drink and age at first sex was not as strong for Black males and females as their White counterparts, respectively. Compared to White males, Black males were less likely to report having had sex without using a condom or birth control after drinking in the past month and during their lifetimes.