Introduction: Advancement in technology has brought notable changes in current methods of diagnosis and treatment in Sexual and Reproductive Health (SRH), which itself has created ethical issues including confidentiality protection for the clients and health care professionals to deal with in SRH services.

Objectives: To develop an ethical guideline regarding confidentiality in SRH services in Iran. Methods: This study was a modified three round Delphi of Iranian academics and clinicians which explored the perception and perspectives of 45 Iranian experts towards confidentiality in SRH services. Purposeful sampling was applied to data collection. Data were collected through sending a series of three questionnaires including a questionnaire contained open-ended questions in round 1. The data underwent three rounds of analysis until a consensus was reached. Results: The panelists’ views were organized to five categories related to confidentiality including 1) right to confidentiality 2) access to information 3) secure management of client’s data 4) third party interests and 5) legal and illegal disclosure. Conclusion: This study has set up an ethical guideline towards confidentiality in SRH services. It can guide health care providers to what they should do and should not do ethically in practice regarding confidentiality in SRH care services.